Integrated Interventional Pain Management PC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

243366 Issued in NY

Legal business name

INTEGRATED INTERVENTIONAL PAIN MANAGEMENT PC

Practice address

20712 Northern Blvd Ste 3
Bayside, NY 11361-3108

Phone

(929) 400-2542

NPI assigned

Jul 6, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Aristide Burducea, DO

Title

President

Phone

(516) 426-3031

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1164918835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20712 NORTHERN BLVD STE 3",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613108",
            "telephone_number": "929-400-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20712 NORTHERN BLVD STE 3",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613108",
            "telephone_number": "929-400-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED INTERVENTIONAL PAIN MANAGEMENT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-06",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "BURDUCEA",
        "authorized_official_first_name": "ARISTIDE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-426-3031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NY",
            "license": "243366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03032322",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pain Clinic/Center in Bayside, NY
• Providers in Bayside, NY by specialty
• Pain Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.