Active NPI
Trinity Pain Management of Staten Island, PLLC
- Pain Medicine Physician
- Staten Island, NY
National Provider Identifier
1174912083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 209053
- Legal business name
- TRINITY PAIN MANAGEMENT OF STATEN ISLAND, PLLC
- Practice address
- 3930 Richmond Ave
Suite 101
Staten Island, NY 10312-5104 - Phone
- (718) 966-1313
- NPI assigned
- Jan 15, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Yvette Abraham, M.D.
- Title
- President
- Phone
- (718) 966-1313
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 209053 | NY | |
| Pain Medicine Physician | 208VP0000X | 209053 | NY | Primary |
Addresses
Primary practice location
3930 Richmond Ave
Suite 101
Staten Island, NY 10312-5104
Mailing address
5 Oakwood CT
Holmdel, NJ 07733-1753
Phone (718) 966-1313
National Provider Directory
National Provider DirectoryLocations
3930 Richmond Ave
Ste 101
Staten Island, NY 10312
Phone (718) 948-7230
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421280000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1423699200000",
"number": "1174912083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 OAKWOOD CT",
"city": "HOLMDEL",
"state": "NJ",
"postal_code": "077331753",
"telephone_number": "718-966-1313",
"fax_number": "718-966-1360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3930 RICHMOND AVE",
"address_2": "SUITE 101",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103125104",
"telephone_number": "718-966-1313"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRINITY PAIN MANAGEMENT OF STATEN ISLAND, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-15",
"last_updated": "2015-02-12",
"status": "A",
"authorized_official_last_name": "ABRAHAM",
"authorized_official_first_name": "YVETTE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-966-1313",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": "NY",
"license": "209053",
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Pain Medicine",
"state": "NY",
"license": "209053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.