Provider Demographics
NPI:1003204538
Name:CEREBROSPINAL NEUROSURGERY SPECIALTIES PC
Entity Type:Organization
Organization Name:CEREBROSPINAL NEUROSURGERY SPECIALTIES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:K
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-603-5647
Mailing Address - Street 1:400 E 71ST ST
Mailing Address - Street 2:#11E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4808
Mailing Address - Country:US
Mailing Address - Phone:347-603-5647
Mailing Address - Fax:347-695-1117
Practice Address - Street 1:400 E 71ST ST
Practice Address - Street 2:#11E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4808
Practice Address - Country:US
Practice Address - Phone:347-603-5647
Practice Address - Fax:347-695-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty