| New Age Neurology Pc | |
|
8778 Bay Pkwy Fl 2 Brooklyn NY 11214-5653 | |
| (718) 889-7445 | |
| Not Available |
| Full Name | New Age Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8778 Bay Pkwy Fl 2, Brooklyn, New York |
| Authorized Official Name and Position | Samir Haddad (PRESIDENT) |
| Authorized Official Contact | 6318854729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Age Neurology Pc 8778 Bay Pkwy Fl 2 Brooklyn NY 11214-5653 Ph: (718) 889-7445 | New Age Neurology Pc 8778 Bay Pkwy Fl 2 Brooklyn NY 11214-5653 Ph: (718) 889-7445 |
| NPI Number | 1427729839 |
|---|---|
| Provider Enumeration Date | 09/24/2021 |
| Last Update Date | 10/09/2024 |
| Certification Date | 10/09/2024 |
| Medicare PECOS PAC ID | 8022406636 |
|---|---|
| Medicare Enrollment ID | O20211102000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427729839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Samir Haddad |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1841248234 PECOS PAC ID: 2860380086 Enrollment ID: I20040309000898 |
| Provider Name | Gertha Boucicault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619285814 PECOS PAC ID: 3870917560 Enrollment ID: I20200728002804 |
| Provider Name | Nadejda Tihomirovs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578159968 PECOS PAC ID: 8921405150 Enrollment ID: I20210930000674 |
| Provider Name | Joseph Durkheim Moise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790329746 PECOS PAC ID: 2567810963 Enrollment ID: I20231124000376 |
| Provider Name | Emily Anari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700506151 PECOS PAC ID: 0143694794 Enrollment ID: I20240517003631 |
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