| New York Neuromodulation Medical Pllc | |
|
235 W 76th St Apt 1b New York NY 10023-8211 | |
| (917) 969-3445 | |
| Not Available |
| Full Name | New York Neuromodulation Medical Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 235 W 76th St Apt 1b, New York, New York |
| Authorized Official Name and Position | Kyle Lapidus (OWNER) |
| Authorized Official Contact | 9179693445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New York Neuromodulation Medical Pllc 235 W 76th St Apt 1b New York NY 10023-8211 Ph: () - | New York Neuromodulation Medical Pllc 235 W 76th St Apt 1b New York NY 10023-8211 Ph: (917) 969-3445 |
| NPI Number | 1558891135 |
|---|---|
| Provider Enumeration Date | 06/15/2017 |
| Last Update Date | 06/15/2017 |
| Medicare PECOS PAC ID | 0446516975 |
|---|---|
| Medicare Enrollment ID | O20171115003124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558891135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Anne E Marmorale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265552285 PECOS PAC ID: 3375692189 Enrollment ID: I20090528000223 |
| Provider Name | Kyle A Lapidus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790927283 PECOS PAC ID: 9436390572 Enrollment ID: I20130801000134 |
| Provider Name | Nancy J Sheehan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861957250 PECOS PAC ID: 6901147461 Enrollment ID: I20190410000332 |
| Provider Name | Sanniu Liu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194076703 PECOS PAC ID: 3971846734 Enrollment ID: I20190517000729 |
| Provider Name | Phanessa Jean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215359336 PECOS PAC ID: 2769893692 Enrollment ID: I20201129000023 |
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