INTERVENTIONAL & MULTI-DISCIPLINARY PAIN MANAGEMENT (NPI# 1538372297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538372297 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL & MULTI-DISCIPLINARY PAIN MANAGEMENT |
| Practice Address |
2500 Nesconset Hwy Bldg 24c Stony Brook NY 11790-2555 |
| Mailing Address |
Po Box 1523 Stony Brook NY 11790-0907 |
| Practice Telephone | 6314440910 |
| Practice Fax Number | 6316893814 |
| Mailing Telephone | 6314440910 |
| Mailing Fax Number | 6316893814 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. LAURINE ANN ERMISH (OFFICE MANAGER) |
| Authorized Official Telephone | 6319410187 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | BLUE CROSS BLUE SHIELD | 096933 | 01 |
| Street Address |
2500 NESCONSET HWY BLDG 24C |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11790-2555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556025 | Marc Yland | Anesthesiology | 2500 Nesconset Hwy, Bldg 24c, Stony Brook, NY 11790-2598 | 2005-05-27 |
| 1417471202 | Brandon M Henkowicz Dc, P.C. | Chiropractor | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2017-08-02 |
| 1902345846 | Michael Fama | Physical Therapist | 2500 Nesconset Hwy, Bldg 22b, Stony Brook, NY 11790-2555 | 2017-02-13 |
| 1790149045 | Three Village Orthodontics | Dentist | 2500 Nesconset Hwy, Building 6-b, Stony Brook, NY 11790-2555 | 2016-04-12 |
| 1790156008 | Morgan Smyth | Physician Assistant | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2015-10-13 |
| 1679964043 | Diana V Carney | Nurse Practitioner | 2500 Nesconset Hwy, Bldg 16, Suite 63, Stony Brook, NY 11790-2555 | 2015-02-06 |
| 1528469442 | Stoney Brook Dental PC | Dentist | 2500 Nesconset Hwy, Suite 11, Stony Brook, NY 11790-2555 | 2014-09-10 |
| 1235545732 | Robert Mosca Physical Therapy, Pllc | Specialist | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2014-07-03 |
| 1841606605 | Shana Anthony | Physical Therapist | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2014-07-01 |
| 1891136073 | Comprehensive Neurology of Long Island PC | Neuromusculoskeletal Medicine & OMM | 2500 Nesconset Hwy, Bldg 5b, Stony Brook, NY 11790-2555 | 2013-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
| 1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
| 1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
| 1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
| 1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| Find all providers in zip 11790 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649734351 | Kaitlyn Scharrenbroich | Specialist | 5 Salem Dr, Stony Brook, NY 11790-1311 | 2019-01-27 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1447619093 | Michelle D'angelo | Specialist | 30 College Dr, Stony Brook, NY 11790-2724 | 2016-02-10 |
| 1720467681 | Pain Management of Stony Brook P.C. | Specialist | 2500 Nesconset Hwy Bldg 24c, Stony Brook, NY 11790-2598 | 2015-05-26 |
| 1669872834 | Jami Hickey | Specialist | 11 Cedar St, Stony Brook, NY 11790-1700 | 2014-08-25 |
| 1154730141 | Elizabeth Zanolli | Specialist | Indoor Sports Complex Stony Brook University, Stony Brook, NY 11794-3500 | 2014-08-05 |
| 1760806772 | Evelyn Haegele | Specialist | 1 Hawks Nest Rd, Stony Brook, NY 11790-1103 | 2014-02-11 |
| 1457699316 | Melissa Horn | Specialist | 20 Magnet St, Stony Brook, NY 11790-2845 | 2013-01-27 |
| 1952648693 | Annemarie Neary | Specialist | 18 Marwood Pl, Stony Brook, NY 11790-2906 | 2013-01-15 |
| 1245574839 | Nguyen Plastic Surgery PC | Specialist | 2500 Nesconset Hwy Bldg 4d, Stony Brook, NY 11790-2551 | 2012-11-20 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11790 |
Please comment or provide details below to improve the information on INTERVENTIONAL & MULTI-DISCIPLINARY PAIN MANAGEMENT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.