Provider Demographics
NPI:1699152934
Name:UNIVERSAL PAIN MANAGEMENT,PC
Entity type:Organization
Organization Name:UNIVERSAL PAIN MANAGEMENT,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YAKOV
Authorized Official - Middle Name:
Authorized Official - Last Name:PERPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-687-2010
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11582-0214
Mailing Address - Country:US
Mailing Address - Phone:718-687-2010
Mailing Address - Fax:718-517-2410
Practice Address - Street 1:2503 27TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2349
Practice Address - Country:US
Practice Address - Phone:718-687-2010
Practice Address - Fax:718-517-2410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034602225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty