Provider Demographics
NPI:1912346420
Name:COMPREHENSIVE PAIN CARE OF LONG ISLAND RONIT ADLER, M.D. PC
Entity type:Organization
Organization Name:COMPREHENSIVE PAIN CARE OF LONG ISLAND RONIT ADLER, M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-661-0400
Mailing Address - Street 1:51 JOHN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2928
Mailing Address - Country:US
Mailing Address - Phone:631-661-0400
Mailing Address - Fax:631-661-0463
Practice Address - Street 1:51 JOHN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2928
Practice Address - Country:US
Practice Address - Phone:631-661-0400
Practice Address - Fax:631-661-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174108AN207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty