# STATE STREET MEDICAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medical Trigger Point
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972256691
- **Authorized official:** STEPHEN LITVAK (OWNER)
- **Authorized official phone:** (516) 851-6087

## Contact information

- **Practice address:** 555 N COUNTRY RD, SAINT JAMES, NY 11780-1444
- **Practice address phone:** (631) 862-1737
- **Mailing address:** 85 S OCEAN AVE, PATCHOGUE, NY 11772-3702
- **Mailing address phone:** (516) 851-6087

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/02/2022
- **Last updated:** 12/08/2022