Empire State Pain & Neuro ,P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

914218 Issued in NY

Legal business name

EMPIRE STATE PAIN & NEURO ,P.C.

Practice address

659 Suffolk Ave
Brentwood, NY 11717-4413

Phone

(631) 654-1120

Fax

(631) 654-1681

NPI assigned

Feb 23, 2012

Last updated

Mar 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Michael Theagene, M.D.

Title

President

Phone

(631) 654-1120

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Danilo Jeremy Cuellar, L. AC., LMT

  • Acupuncturist
  • Suffern, NY
  • NPI 1316165228
  NPD (past)

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1558634477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 SUFFOLK AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174413",
            "telephone_number": "631-654-1120",
            "fax_number": "631-654-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 SUFFOLK AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174413",
            "telephone_number": "631-654-1120",
            "fax_number": "631-654-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPIRE STATE PAIN & NEURO ,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "THEAGENE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-654-1120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "914218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nneka Pamela Egbuna, LPN
• Uchenna Egbuna
• Timothy Eisemann, RN
• Zeinab S. Elbaz, M.D. ,FRCPC
• Elvara Health LLC
• Epps Therapeutic Partners Co. (none)
• Brianna Erario
• Edgar Escobar, LMSW
• Andrew Espinosa
• Boris Espinoza, M.D.

• Physical Medicine & Rehabilitation Physician in Brentwood, NY
• Providers in Brentwood, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.