| Physician Last Name: | N.Y.C. Pain Relief Medical |
| Physician First Name: | P.C. |
| Physician Middle Name: | |
| Address: | 200 Central Park South #20A
New York, New York 10019 |
| License Number: | 171302 |
| License Type: | |
| Year of Birth: |
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| Effective Date: | 05/14/2002 |
| Action Description for DOH Webpage: | Revocation of certificate of incorporation |
| Misconduct Description for DOH Webpage: | The corporation admitted to the charge of failing to comply with the requirements of New York State Business Corporation Law Section 1503(a). |
| License Limitations or Conditions for DOH Webpage: | |
| Board Order: |
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