| New York Neurology And Pain Management | |
|
1931 Richmond Ave Ste 201 Staten Island NY 10314-3930 | |
| (718) 477-9300 | |
| (718) 477-9301 |
| Full Name | New York Neurology And Pain Management |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1931 Richmond Ave Ste 201, Staten Island, New York |
| Authorized Official Name and Position | Shan Nagendra (OWNER) |
| Authorized Official Contact | 7184779300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New York Neurology And Pain Management 1931 Richmond Ave Ste 201 Staten Island NY 10314-3930 Ph: (718) 477-9300 | New York Neurology And Pain Management 1931 Richmond Ave Ste 201 Staten Island NY 10314-3930 Ph: (718) 477-9300 |
| NPI Number | 1447995568 |
|---|---|
| Provider Enumeration Date | 05/03/2022 |
| Last Update Date | 05/03/2022 |
| Certification Date | 05/03/2022 |
| Medicare PECOS PAC ID | 4284017856 |
|---|---|
| Medicare Enrollment ID | O20220815000957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447995568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Shan Nagendra |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164533659 PECOS PAC ID: 2062467442 Enrollment ID: I20050526000575 |
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