Provider Demographics
NPI:1104922970
Name:NEUROLOGY ASSOCIATES, LLP
Entity type:Organization
Organization Name:NEUROLOGY ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-962-2443
Mailing Address - Street 1:56 E 1ST ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2714
Mailing Address - Country:US
Mailing Address - Phone:607-962-2443
Mailing Address - Fax:607-962-3571
Practice Address - Street 1:56 E 1ST ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2714
Practice Address - Country:US
Practice Address - Phone:607-962-2443
Practice Address - Fax:607-962-3571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01534096Medicaid
NY01534096Medicaid