NPIMap

Organization Active NPI

Statewide Interventional Pain Medicine, PC

  • Interventional Pain Medicine Physician
  • Mineola, NY
National Provider Identifier
1407004781
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
STATEWIDE INTERVENTIONAL PAIN MEDICINE, PC
Practice address
40 E 2ND St
Mineola, NY 11501-3504
Phone
(516) 739-3862
Fax
(516) 747-4783
NPI assigned
Aug 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Authorized official

Name
Dr. David Adin, DO
Title
Owner
Phone
(516) 739-3862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X NY Primary

Addresses

Primary practice location

40 E 2ND St
Mineola, NY 11501-3504

Mailing address

40 E 2ND St
P.O. Box 191
Mineola, NY 11501-3504
Phone (516) 739-3862

National Provider Directory

National Provider Directory
Tax ID family
Statewide Interventional Pain Medicine PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

40 E 2nd St
Mineola, NY 11501

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1407004781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E 2ND ST",
            "address_2": "P.O. BOX 191",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013504",
            "telephone_number": "516-739-3862",
            "fax_number": "516-747-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 E 2ND ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013504",
            "telephone_number": "516-739-3862",
            "fax_number": "516-747-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE INTERVENTIONAL PAIN MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "ADIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-739-3862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.