Organization
NEW YORK ISPINE SPECIALIST MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADAN K RAJ (MD)
(516) 441-5739
Entity
Organization
Contact information
Practice address
600 NORTHERN BLVD, GREAT NECK, NY 11021-5206
(516) 441-5739
Mailing address
11 HOLIDAY POND RD, JERICHO, NY 11753-1154
(516) 441-5739
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
07/15/2015
Last updated
09/09/2015
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