| Adult And Child Neurology Pc | |
|
3613 30th Ave Astoria NY 11103-4329 | |
| (800) 200-8196 | |
| (914) 368-8343 |
| Full Name | Adult And Child Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3613 30th Ave, Astoria, New York |
| Authorized Official Name and Position | Maja Ilic (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9143581162 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult And Child Neurology Pc 21 Kingston Rd Scarsdale NY 10583-1147 Ph: (914) 358-1162 | Adult And Child Neurology Pc 3613 30th Ave Astoria NY 11103-4329 Ph: (800) 200-8196 |
| NPI Number | 1982261194 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 09/01/2023 |
| Certification Date | 09/01/2023 |
| Medicare PECOS PAC ID | 6204163801 |
|---|---|
| Medicare Enrollment ID | O20190805002936 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982261194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | (* (Not Available)) | Primary |
| Provider Name | Samuel Apeatu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013939545 PECOS PAC ID: 5991886491 Enrollment ID: I20080122000426 |
| Provider Name | Ellen I Edgar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326343625 PECOS PAC ID: 4486838885 Enrollment ID: I20110408000585 |
| Provider Name | Maja Ilic |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255652863 PECOS PAC ID: 8820250335 Enrollment ID: I20120430000341 |
| Provider Name | Vesna M Micic |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811121502 PECOS PAC ID: 6002940400 Enrollment ID: I20160517001434 |
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