Provider Demographics
NPI:1124630215
Name:NY NEUROCARE MEDICAL SERVICES, PLLC
Entity type:Organization
Organization Name:NY NEUROCARE MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-996-9888
Mailing Address - Street 1:8321 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3001
Mailing Address - Country:US
Mailing Address - Phone:718-996-9888
Mailing Address - Fax:718-996-2888
Practice Address - Street 1:8321 20TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3001
Practice Address - Country:US
Practice Address - Phone:718-996-9888
Practice Address - Fax:718-996-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty