Provider Demographics
NPI:1548436124
Name:MANHATTAN PAIN MANAGEMENT & SPORTS MEDICINE
Entity type:Organization
Organization Name:MANHATTAN PAIN MANAGEMENT & SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAN
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELGLASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-588-0980
Mailing Address - Street 1:151 E 80TH ST
Mailing Address - Street 2:2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0442
Mailing Address - Country:US
Mailing Address - Phone:212-588-0980
Mailing Address - Fax:212-517-3919
Practice Address - Street 1:635 MADISON AVE
Practice Address - Street 2:13TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1009
Practice Address - Country:US
Practice Address - Phone:212-588-0980
Practice Address - Fax:212-588-0983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1480232081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY25D121Medicare PIN
NYBU11554Medicare UPIN