Provider Demographics
NPI:1164629200
Name:M.SHAREEFF.NEUROLOGY,P.C.
Entity Type:Organization
Organization Name:M.SHAREEFF.NEUROLOGY,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANEJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-693-0700
Mailing Address - Street 1:1100 SHAMES DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1765
Mailing Address - Country:US
Mailing Address - Phone:516-693-0700
Mailing Address - Fax:
Practice Address - Street 1:M.SHAREEFF.NEUROLOGY,P.C.
Practice Address - Street 2:158,EAST MAIN STREET,#1,
Practice Address - City:HUNTINGTON,
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-271-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2259432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH89014Medicare UPIN
NY485N61Medicare ID - Type Unspecified