Organization
ADVANCED SPINE CARE AND PAIN MANAGEMENT OF NEW YORK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAILESH S PATHARE M.D. (OWNER)
(718) 818-4892
Entity
Organization
Contact information
Practice address
565 JEWETT AVE, STATEN ISLAND, NY 10302-2654
(718) 701-6010
(718) 447-7831
Mailing address
565 JEWETT AVE, STATEN ISLAND, NY 10302-2654
(718) 701-6010
(718) 447-7831
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012J1
EMPIRE BC BS
NY
05
—
02006962
—
NY
01
—
173446
ELDERPLAN
NY
01
—
205677
HIP
NY
01
—
355618300
US DEPT OF LABOR
NY
01
—
4C4399
PHS/HEALTHNET
NY
01
—
8799893
GHI
NY
01
—
DA0552
RAILROAD MEDICARE
NY
01
—
P1883750
OXFORD
NY
Enumeration date
10/24/2006
Last updated
04/28/2021
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