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 provides Physical Medicine & Rehabilitation Physician services 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 Not confirmed with CMS for 14 years — call before visiting
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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