Provider Demographics
NPI:1215703673
Name:PURELY PROFESSIONAL PAIN MANAGEMENT P.C.
Entity type:Organization
Organization Name:PURELY PROFESSIONAL PAIN MANAGEMENT P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:APPLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-553-0505
Mailing Address - Street 1:22 HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6333
Mailing Address - Country:US
Mailing Address - Phone:631-553-0505
Mailing Address - Fax:
Practice Address - Street 1:22 HARBOR DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6333
Practice Address - Country:US
Practice Address - Phone:631-553-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty