| Organization Name: | BROOKLYN PAIN MANAGEMENT PC |
| NPI Number: | 1306279203 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MEHRDAD HEDAYATNIA (OWNER) |
| Mailing Address: | 370 Bay Ridge Pkwy Brooklyn |
| State: | NY US |
| Postal Code: | 112093176 |
| Phone Number: | 7183021111 |
| Fax Number: | 7185069702 |
| NPI Enumeration Date: | 08/14/2013 |
| NPI Last Update Date: | 08/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 101301 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |