Provider Demographics
NPI:1235208406
Name:CNY NEUROLOGICAL CONSULTING PLLC
Entity Type:Organization
Organization Name:CNY NEUROLOGICAL CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUKRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-634-5550
Mailing Address - Street 1:5000 BRITTONFIELD PARKWAY
Mailing Address - Street 2:SUITE A116
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057
Mailing Address - Country:US
Mailing Address - Phone:315-634-5550
Mailing Address - Fax:315-795-2125
Practice Address - Street 1:5000 BRITTONFIELD PKWY
Practice Address - Street 2:A116
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057
Practice Address - Country:US
Practice Address - Phone:315-634-5550
Practice Address - Fax:315-634-5553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1952452084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty