Provider Demographics
NPI:1235325747
Name:NYC MEDICAL & NEUROLOGICAL OFFICES, P.C.
Entity Type:Organization
Organization Name:NYC MEDICAL & NEUROLOGICAL OFFICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLZAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-454-2222
Mailing Address - Street 1:PO BOX 747939
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-7939
Mailing Address - Country:US
Mailing Address - Phone:718-454-2222
Mailing Address - Fax:718-264-0257
Practice Address - Street 1:9131 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5555
Practice Address - Country:US
Practice Address - Phone:718-454-2222
Practice Address - Fax:718-264-0257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202459-12084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02501Medicare PIN