Innovation Spine Medical PC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

INNOVATION SPINE MEDICAL PC

Practice address

4 Weber Ave
Malverne, NY 11565-1742

Phone

(516) 599-3999

Fax

(516) 887-8106

NPI assigned

Aug 9, 2010

Organization subpart

No

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

Authorized official

Name

Laura Flint

Title

Billing Manager

Phone

(516) 599-3999

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dmitriy Fuzaylov, MD

  • Pain Medicine (Anesthesiology) Physician
  • Rego Park, NY
  • NPI 1093974040
  NPD

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1669787180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WEBER AVE",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651742",
            "telephone_number": "516-599-3999",
            "fax_number": "516-887-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WEBER AVE",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651742",
            "telephone_number": "516-599-3999",
            "fax_number": "516-887-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION SPINE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-09",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "FLINT",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "516-599-3999"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Joseph Heiss
• Keith Joseph Hoerlein, RPH
• Elizabeth K Hoistad, P.T.
• Ashley Kathleen Holder
• Sotiria Hountas, RN
• Jennifer Diane Kadel, ACNP
• Heather Kane
• Mark Kaplan, RPH
• Melanie Kaplan, MHC-LP, CASAC-P
• Steven M Katz, D.M.D.

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Malverne, NY
• Providers in Malverne, NY by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.