Provider Demographics
NPI:1265016174
Name:ON DEMAND NEUROLOGY PA
Entity Type:Organization
Organization Name:ON DEMAND NEUROLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BURSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-272-1134
Mailing Address - Street 1:335 MADISON AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4675
Mailing Address - Country:US
Mailing Address - Phone:313-887-0960
Mailing Address - Fax:
Practice Address - Street 1:113 S MONROE ST FL 1
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-1529
Practice Address - Country:US
Practice Address - Phone:650-387-6322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty