90TH Street Surgical PLLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

90TH STREET SURGICAL PLLC

Practice address

435 E 90TH St Ste 201
New York, NY 10128-5103

Phone

(315) 302-9073

NPI assigned

Sep 27, 2024

Last updated

Sep 27, 2024By 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

David Davydov, OPA-C

Title

Director

Phone

(315) 302-9073

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.

• Didier A. Demesmin, M.D.

  • Interventional Pain Medicine Physician
  • Somerset, NJ
  • NPI 1336170216
  NPD (past)

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1619795887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 E 90TH ST STE 201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285103",
            "telephone_number": "315-302-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 E 90TH ST STE 201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285103",
            "telephone_number": "315-302-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "90TH STREET SURGICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "DAVYDOV",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "315-302-9073",
        "authorized_official_credential": "OPA-C"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Interventional Pain Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.