Organization
1155 NEURO PAIN SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIKAS VARMA (MBBS)
(718) 460-1111
Entity
Organization
Contact information
Practice address
16408 65TH AVE, FRESH MEADOWS, NY 11365-1803
(718) 460-1111
(718) 460-5111
Mailing address
1155 NORTHERN BLVD, MANHASSET, NY 11030-3040
(718) 460-1111
(718) 460-5111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
203454
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08047
GHI MEDICARE
NY
01
—
W38531
EMPIRE MEDICARE
NY
Enumeration date
01/08/2007
Last updated
03/14/2008
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