Provider Demographics
NPI:1215370390
Name:NEUROLOGY CLIFTON PARK
Entity Type:Organization
Organization Name:NEUROLOGY CLIFTON PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SITE MEDICAL MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:NASEER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOWDHREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-381-1800
Mailing Address - Street 1:939 ROUTE 146
Mailing Address - Street 2:SUITE 810
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3662
Mailing Address - Country:US
Mailing Address - Phone:518-381-1800
Mailing Address - Fax:518-381-1801
Practice Address - Street 1:939 ROUTE 146
Practice Address - Street 2:SUITE 810
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3662
Practice Address - Country:US
Practice Address - Phone:518-381-1800
Practice Address - Fax:518-381-1801
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPITALCARE MEDICAL GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty