| East Greenbush Neurology Office, Pllc | |
|
1528 Columbia Tpke Castleton NY 12033-9584 | |
| (518) 694-3053 | |
| (518) 694-3056 |
| Full Name | East Greenbush Neurology Office, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1528 Columbia Tpke, Castleton, New York |
| Authorized Official Name and Position | Hani Midani (SOLE PROPIETOR) |
| Authorized Official Contact | 5186943053 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Greenbush Neurology Office, Pllc 1528 Columbia Tpke Castleton NY 12033-9584 Ph: (518) 694-3053 | East Greenbush Neurology Office, Pllc 1528 Columbia Tpke Castleton NY 12033-9584 Ph: (518) 694-3053 |
| NPI Number | 1013144823 |
|---|---|
| Provider Enumeration Date | 06/18/2009 |
| Last Update Date | 07/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013144823 | NPI | - | NPPES |
| BB5753 | Other | NY | MEDICARE ID-TYPE UNSPECIFIED |
| 01954374 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 214014 (New York) | Primary |