Bayside Pain Management PC

Organization Active NPI Pain Medicine Physician · Deer Park, NY

NPI 1184008658 · NPPES record last updated Jul 15, 2015

Key facts

NPI
1184008658
Entity type
Organization (NPI type 2)
Primary specialty
Pain Medicine Physician 208VP0000X
License
243366 (NY)
Legal business name
BAYSIDE PAIN MANAGEMENT PC
Practice address
247 W 16TH St
Deer Park, NY 11729-5819
Phone
(646) 982-7281
NPI assigned
Jul 15, 2015
Organization subpart
No

Authorized official

Name
Aristide Burducea, D.O.
Title
President
Phone
(718) 220-0439

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Bayside Pain Management (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208VP0000X 243366 NY Yes

Addresses

Primary practice location

247 W 16TH St
Deer Park, NY 11729-5819

Mailing address

247 W 16TH St
Deer Park, NY 11729-5819

Other identifiers

IdentifierTypeStateIssuer
03032322MedicaidNY

Other providers in Deer Park, NY

All providers in Deer Park, NY · Pain Medicine Physician in New York

Sources for this page

Verify at the official NPI Registry.