Cny Neurodiagnostics Pllc | |
1101 Erie Blvd E Syracuse NY 13210-1148 | |
(315) 481-8777 | |
(315) 782-8699 |
Full Name | Cny Neurodiagnostics Pllc |
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Speciality | Psychiatry & Neurology |
Location | 1101 Erie Blvd E, Syracuse, New York |
Authorized Official Name and Position | Samah Omer Mohiuddin (OWNER) |
Authorized Official Contact | 3154818777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Cny Neurodiagnostics Pllc 445 Factory St Watertown NY 13601-2729 Ph: (315) 782-4207 | Cny Neurodiagnostics Pllc 1101 Erie Blvd E Syracuse NY 13210-1148 Ph: (315) 481-8777 |
NPI Number | 1619367885 |
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Provider Enumeration Date | 01/27/2015 |
Last Update Date | 01/27/2015 |
Medicare PECOS PAC ID | 9335456045 |
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Medicare Enrollment ID | O20150914000522 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619367885 | NPI | - | NPPES |
PENDING | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 266512 (New York) | Primary |
Provider Name | Samah Mohiuddin |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1336455112 PECOS PAC ID: 0143462614 Enrollment ID: I20130813000279 |
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