Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Empire State Pain & Neuro , PC

Organization Physical Medicine & Rehabilitation Physician · NPI 1558634477

Empire State Pain & Neuro , PC is a Physical Medicine & Rehabilitation Physician in Brentwood, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

659 Suffolk Ave
Brentwood, NY 11717-4413
Phone: (631) 654-1120
Fax: (631) 654-1681
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 914218 (NY)

Record details

NPI number1558634477
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Samuel Theagene — President · (631) 654-1120
NPI enumeratedFebruary 23, 2012
Last updated in NPPESMarch 20, 2012
Mailing address659 Suffolk Ave, Brentwood, NY 11717-4413

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