Organization
ORIGIN PAIN MANAGEMENT AND MEDICAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GETAHUN KIFLE MD (OWNER)
(718) 462-1100
Entity
Organization
Contact information
Practice address
486 LINCOLN PL, BROOKLYN, NY 11238-6202
(718) 462-1100
(718) 462-1900
Mailing address
110 LEAHY ST, JERICHO, NY 11753-1618
(718) 462-1100
(718) 462-1900
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01909351
—
NY
Enumeration date
02/06/2008
Last updated
07/21/2022
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