Roosevelt Ave Pain Medicine PLLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

ROOSEVELT AVE PAIN MEDICINE PLLC

Practice address

9109 Roosevelt Ave # 201
Jackson Heights, NY 11372-7995

Phone

(718) 433-9293

NPI assigned

Jul 24, 2023

Organization subpart

No

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

Authorized official

Name

Ashraf K Salem, MD

Title

President/Owner

Phone

(929) 920-9212

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1689354565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 RALPH AVE # 637",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 ROOSEVELT AVE # 201",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727995",
            "telephone_number": "718-433-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT AVE PAIN MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "SALEM",
        "authorized_official_first_name": "ASHRAF",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "929-920-9212",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Romeo, D.O
• Madeleine Isabel Romero, LMSW
• Daniella A Rondanelli, LMSW
• Metherlyn Rondon, LMHC
• Bonij Ronjan
• Roosevelt Cardio Vascular Diagnostic, P.C.
• Roosevelt City Pharmacy Inc
• Roosevelt Dental Care II P.C.
• Roosevelt Dental Care P.C.
• Roosevelt Drug Corp

• Interventional Pain Medicine Physician in Jackson Heights, NY
• Providers in Jackson Heights, 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 Jul 24, 2023; 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.