Provider Demographics
NPI:1104677483
Name:NEUROLOGICAL CARE, PC
Entity type:Organization
Organization Name:NEUROLOGICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-612-7485
Mailing Address - Street 1:1584 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3433
Mailing Address - Country:US
Mailing Address - Phone:718-621-5800
Mailing Address - Fax:
Practice Address - Street 1:1135 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3642
Practice Address - Country:US
Practice Address - Phone:718-621-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEUROLOGICAL CARE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center