Provider Demographics
NPI:1962724922
Name:NEUROASIS NEUROLOGY WELLNESS
Entity type:Organization
Organization Name:NEUROASIS NEUROLOGY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GERACI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-227-2368
Mailing Address - Street 1:350 BROADWAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3911
Mailing Address - Country:US
Mailing Address - Phone:212-227-2368
Mailing Address - Fax:212-227-2369
Practice Address - Street 1:350 BROADWAY
Practice Address - Street 2:SUITE 205
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3911
Practice Address - Country:US
Practice Address - Phone:212-227-2368
Practice Address - Fax:212-227-2369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2033562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA60064Medicare UPIN
NYH01358Medicare PIN