Statewide Interventional Pain Medicine, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

224928 Issued in NY

Legal business name

STATEWIDE INTERVENTIONAL PAIN MEDICINE, P.C.

Practice address

3825 Astoria Blvd
Astoria, NY 11103-3608

Phone

(718) 758-9600

Fax

(718) 758-9602

NPI assigned

Jun 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. David Adin, MD

Title

President

Phone

(718) 758-9600

Specialties & licenses 1

Addresses

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.

• Statewide Interventional Pain Medicine, PC

  • Interventional Pain Medicine Physician
  • Mineola, NY
  • NPI 1407004781
  NPD tax ID

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1669609582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MARCUS AVENUE",
            "address_2": "PO BOX 3757",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "718-758-9600",
            "fax_number": "718-758-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 ASTORIA BLVD",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033608",
            "telephone_number": "718-758-9600",
            "fax_number": "718-758-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE INTERVENTIONAL PAIN MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "ADIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-758-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "224928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Stadlen
• Joanne Stalzer, RN
• Costantinos Stamboulis, OTR/L
• George Stamboulis, PT, DPT
• Starshine LLC
• Ioannis Stathopoulos, MD
• Stuart Lance Stauber, MD
• Marzena Stec, PT
• Despina Stefanidis
• Gary David Steinman, MD

• Specialist in Astoria, NY
• Providers in Astoria, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.