Provider Demographics
NPI:1992562714
Name:SPRAINSPINE PAINCARE LLC
Entity type:Organization
Organization Name:SPRAINSPINE PAINCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-699-7311
Mailing Address - Street 1:350 E 207TH ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-4213
Mailing Address - Country:US
Mailing Address - Phone:845-699-7311
Mailing Address - Fax:
Practice Address - Street 1:350 E 207TH ST APT 2B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-4213
Practice Address - Country:US
Practice Address - Phone:845-699-7311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies