| Kingston Neuro. Broadway | |
|
365 Broadway Kingston NY 12401-5151 | |
| (845) 331-5165 | |
| (845) 331-6238 |
| Full Name | Kingston Neuro. Broadway |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 365 Broadway, Kingston, New York |
| Authorized Official Name and Position | Ronald Tatelbaum (PRESIDENT) |
| Authorized Official Contact | 8454759635 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingston Neuro. Broadway 1351 Route 55 Suite 200 Lagrangeville NY 12540-5108 Ph: (845) 475-9635 | Kingston Neuro. Broadway 365 Broadway Kingston NY 12401-5151 Ph: (845) 331-5165 |
| NPI Number | 1669885513 |
|---|---|
| Provider Enumeration Date | 06/09/2014 |
| Last Update Date | 08/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669885513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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