| Suffolk Brain And Nerve, Pllc | |
|
1010 Route 112 Ste 300 Port Jefferson Station NY 11776-3386 | |
| (631) 410-9420 | |
| (631) 410-2017 |
| Full Name | Suffolk Brain And Nerve, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1010 Route 112 Ste 300, Port Jefferson Station, New York |
| Authorized Official Name and Position | Christopher M Sinclair (OWNER) |
| Authorized Official Contact | 6315607290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suffolk Brain And Nerve, Pllc 1010 Route 112 Ste 300 Port Jefferson Station NY 11776-3386 Ph: (631) 410-9420 | Suffolk Brain And Nerve, Pllc 1010 Route 112 Ste 300 Port Jefferson Station NY 11776-3386 Ph: (631) 410-9420 |
| NPI Number | 1083132658 |
|---|---|
| Provider Enumeration Date | 09/05/2017 |
| Last Update Date | 02/25/2020 |
| Certification Date | 02/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083132658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 232434 (New York) | Primary |
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