Organization
MODERN PAIN & SPINE PC
Active
Organization
MODERN PAIN & SPINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ATHANASIOS KOSTANDINOS MANOLE MD (MEDICAL DIRECTOR)
(505) 529-8511
Entity
Organization
Contact information
Practice address
1540 JUAN TABO BLVD NE STE A, ALBUQUERQUE, NM 87112-4460
(505) 529-8511
Mailing address
1540 JUAN TABO BLVD NE STE A, ALBUQUERQUE, NM 87112-4460
(595) 519-8511
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
10/01/2020
Last updated
06/10/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up