Provider Demographics
NPI:1104406750
Name:COMPREHENSIVE NEUROLOGICAL CARE PA
Entity type:Organization
Organization Name:COMPREHENSIVE NEUROLOGICAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTROVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-634-9425
Mailing Address - Street 1:18975 COLLINS AVE UNIT 1602
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2357
Mailing Address - Country:US
Mailing Address - Phone:347-634-9425
Mailing Address - Fax:212-962-2050
Practice Address - Street 1:18975 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:SUNNY ISL BCH
Practice Address - State:FL
Practice Address - Zip Code:33160-2300
Practice Address - Country:US
Practice Address - Phone:347-634-9425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty