| Island Neuro Care, Pc | |
|
924 N Broadway Ste 2 Massapequa NY 11758-2303 | |
| (516) 520-5507 | |
| (516) 520-5493 |
| Full Name | Island Neuro Care, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 924 N Broadway Ste 2, Massapequa, New York |
| Authorized Official Name and Position | Birendra K Trivedi (OWNER) |
| Authorized Official Contact | 5165205507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Island Neuro Care, Pc 4230 Hempstead Tpke Suite 106 Bethpage NY 11714-5700 Ph: (516) 520-5507 | Island Neuro Care, Pc 924 N Broadway Ste 2 Massapequa NY 11758-2303 Ph: (516) 520-5507 |
| NPI Number | 1821263229 |
|---|---|
| Provider Enumeration Date | 04/25/2008 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Medicare PECOS PAC ID | 3870787583 |
|---|---|
| Medicare Enrollment ID | O20101027000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821263229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 209199 (New York) | Primary |
| Provider Name | Padmaja Aradhya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427022391 PECOS PAC ID: 3476452822 Enrollment ID: I20040105000519 |
| Provider Name | Birendra K Trivedi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992750244 PECOS PAC ID: 3577757285 Enrollment ID: I20101110000849 |
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