| NPI | 1396498309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDHARTH PANCHAMIA Owner/Manager 917-202-9026 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2024-08-19 |