| Pediatric Neurology Pc | |
|
210 N Central Ave Ste 250 Hartsdale NY 10530-1949 | |
| (914) 358-1162 | |
| (914) 368-8343 |
| Full Name | Pediatric Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 210 N Central Ave Ste 250, Hartsdale, New York |
| Authorized Official Name and Position | Maja Ilic (MD) |
| Authorized Official Contact | 9143581162 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Neurology Pc 8 Murray Hill Rd Scarsdale NY 10583-2804 Ph: (914) 358-1162 | Pediatric Neurology Pc 210 N Central Ave Ste 250 Hartsdale NY 10530-1949 Ph: (914) 358-1162 |
| NPI Number | 1124573522 |
|---|---|
| Provider Enumeration Date | 08/16/2016 |
| Last Update Date | 09/01/2023 |
| Certification Date | 09/01/2023 |
| Medicare PECOS PAC ID | 2163798349 |
|---|---|
| Medicare Enrollment ID | O20171017001172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124573522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | 259249 (New York) | Primary |
| Provider Name | Maja Ilic |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255652863 PECOS PAC ID: 8820250335 Enrollment ID: I20120430000341 |
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