Organization
EASTERN PAIN MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIMALA UPADHYAYULA (MANAGER)
(845) 471-0014
Entity
Organization
Contact information
Practice address
1003 MAIN ST, FISHKILL, NY 12524-1786
(845) 471-0013
(845) 613-2493
Mailing address
1003 MAIN ST, FISHKILL, NY 12524-1786
(845) 471-0013
(845) 613-2493
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
225874
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03482024
—
NY
Enumeration date
10/21/2011
Last updated
03/25/2020
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