Provider Demographics
NPI:1407804008
Name:NEUROSURGICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SISTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-305-1182
Mailing Address - Street 1:710 W 168TH ST
Mailing Address - Street 2:ROOM 425
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3726
Mailing Address - Country:US
Mailing Address - Phone:212-305-1182
Mailing Address - Fax:212-305-3629
Practice Address - Street 1:710 W 168TH ST
Practice Address - Street 2:ROOM 425
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3726
Practice Address - Country:US
Practice Address - Phone:212-305-1182
Practice Address - Fax:212-305-3629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW18711Medicare ID - Type UnspecifiedGROUP NUMBER