Organization
SPINE SPORTS & INTERVENTIONAL PAIN MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJEEV AGARWAL MD (OWNER)
(631) 486-9100
Entity
Organization
Contact information
Practice address
186 MONTAGUE ST, BROOKLYN, NY 11201-3634
(718) 358-1700
(718) 489-4101
Mailing address
495 CENTRAL PARK AVE, SUITE 303, SCARSDALE, NY 10583-1068
(914) 713-8774
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
305S00000X
Point of Service
2439891
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02899925
—
NY
Enumeration date
07/07/2014
Last updated
01/03/2019
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