East Greenbush Neurology Office, Pllc | |
1528 Columbia Tpke Castleton NY 12033-9584 | |
(518) 694-3053 | |
(518) 694-3056 |
Full Name | East Greenbush Neurology Office, Pllc |
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Speciality | Psychiatry & Neurology - Neurology |
Location | 1528 Columbia Tpke, Castleton, New York |
Authorized Official Name and Position | Hani Midani (SOLE PROPIETOR) |
Authorized Official Contact | 5186943053 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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East Greenbush Neurology Office, Pllc 1528 Columbia Tpke Castleton NY 12033-9584 Ph: (518) 694-3053 | East Greenbush Neurology Office, Pllc 1528 Columbia Tpke Castleton NY 12033-9584 Ph: (518) 694-3053 |
NPI Number | 1013144823 |
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Provider Enumeration Date | 06/18/2009 |
Last Update Date | 07/28/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013144823 | NPI | - | NPPES |
BB5753 | Other | NY | MEDICARE ID-TYPE UNSPECIFIED |
01954374 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 214014 (New York) | Primary |