Provider Demographics
NPI:1164786323
Name:NEUROLOGY MEDICAL SERVICES OF LONG ISLAND, P.C.
Entity Type:Organization
Organization Name:NEUROLOGY MEDICAL SERVICES OF LONG ISLAND, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-430-5091
Mailing Address - Street 1:229 7TH ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5766
Mailing Address - Country:US
Mailing Address - Phone:516-430-5091
Mailing Address - Fax:
Practice Address - Street 1:229 7TH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5766
Practice Address - Country:US
Practice Address - Phone:516-430-5091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2050632084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty