| Eriver Neurology Of Ny Llc | |
|
21 Fox Street Suite 102 Poughkeepsie NY 12601-4723 | |
| (845) 452-9750 | |
| (845) 452-9751 |
| Full Name | Eriver Neurology Of Ny Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 21 Fox Street, Poughkeepsie, New York |
| Authorized Official Name and Position | Kathy Ryan (OFFICE MANAGER) |
| Authorized Official Contact | 8454529750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eriver Neurology Of Ny Llc 21 Fox Street Suite 102 Poughkeepsie NY 12601-4723 Ph: (845) 452-9750 | Eriver Neurology Of Ny Llc 21 Fox Street Suite 102 Poughkeepsie NY 12601-4723 Ph: (845) 452-9750 |
| NPI Number | 1811064520 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 04/19/2023 |
| Certification Date | 04/19/2023 |
| Medicare PECOS PAC ID | 5193759033 |
|---|---|
| Medicare Enrollment ID | O20050921000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811064520 | NPI | - | NPPES |
| 02724909 | Medicaid | NY |
| Provider Name | John F Mcnulty |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1255314332 PECOS PAC ID: 5294728598 Enrollment ID: I20040405000271 |
| Provider Name | Samuel E Koszer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982697975 PECOS PAC ID: 9537193529 Enrollment ID: I20050920000325 |
| Provider Name | Rose M Mathew |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679638886 PECOS PAC ID: 4587720776 Enrollment ID: I20090313000348 |
| Provider Name | Glenn Y Castaneda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821090333 PECOS PAC ID: 3476587312 Enrollment ID: I20111208000425 |
| Provider Name | Laura Shaw Boylan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225057003 PECOS PAC ID: 3274685714 Enrollment ID: I20230406001383 |
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