Provider Demographics
NPI:1487987632
Name:NASR SPINE & PAIN MANAGEMENT P.C.
Entity type:Organization
Organization Name:NASR SPINE & PAIN MANAGEMENT P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HANY
Authorized Official - Middle Name:
Authorized Official - Last Name:NASR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-309-2642
Mailing Address - Street 1:36 HURON ST
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-4313
Mailing Address - Country:US
Mailing Address - Phone:917-309-2642
Mailing Address - Fax:
Practice Address - Street 1:36 HURON ST
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-4313
Practice Address - Country:US
Practice Address - Phone:917-309-2642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No283X00000XHospitalsRehabilitation Hospital
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric