Organization
NEW YORK INTERVENTIONAL SPINE AND PAIN MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDULQUADER KHAN MD (PRESIDENT)
(646) 732-7139
Entity
Organization
Contact information
Practice address
405 5TH AVE, BROOKLYN, NY 11215-3315
(646) 732-7139
(718) 768-7303
Mailing address
405 5TH AVE, BROOKLYN, NY 11215-3315
(646) 732-7139
(718) 768-7303
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
251646
NY
261QP3300X
Pain Clinic/Center
Primary
251646
NY
363A00000X
Physician Assistant
000135
NY
363A00000X
Physician Assistant
003681
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03289269
—
NY
Enumeration date
07/20/2012
Last updated
08/03/2021
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