Provider Demographics
NPI:1184847634
Name:SCHENECTADY NEUROLOGICAL CONSULTANTS, PC
Entity Type:Organization
Organization Name:SCHENECTADY NEUROLOGICAL CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:A
Authorized Official - Last Name:HEALEY
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:518-381-9202
Mailing Address - Street 1:1401 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3009
Mailing Address - Country:US
Mailing Address - Phone:518-381-9202
Mailing Address - Fax:518-381-1182
Practice Address - Street 1:1401 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-3009
Practice Address - Country:US
Practice Address - Phone:518-381-9202
Practice Address - Fax:518-381-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU271OtherGROUP ID#
NYWM0001OtherGROUP ID#
NY02732992Medicaid
NYBA0717Medicare ID - Type UnspecifiedGROUP ID #