Provider Demographics
NPI:1104187418
Name:WINTHROP NEURO-SCIENCE MEDICAL PC
Entity Type:Organization
Organization Name:WINTHROP NEURO-SCIENCE MEDICAL 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:MENNITI
Authorized Official - Last Name:STECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-663-4525
Mailing Address - Street 1:200 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4235
Mailing Address - Country:US
Mailing Address - Phone:516-663-4525
Mailing Address - Fax:516-663-4532
Practice Address - Street 1:200 OLD COUNTRY RD
Practice Address - Street 2:SUITE 370
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4235
Practice Address - Country:US
Practice Address - Phone:516-663-4525
Practice Address - Fax:516-663-4532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty