Provider Demographics
NPI:1417371816
Name:SCHENECTADY NEUROLOGICAL CONSULTANTS PC
Entity Type:Organization
Organization Name:SCHENECTADY NEUROLOGICAL CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:A
Authorized Official - Last Name:HEALEY
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:518-381-9202
Mailing Address - Street 1:1401 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3023
Mailing Address - Country:US
Mailing Address - Phone:518-381-9202
Mailing Address - Fax:518-381-1182
Practice Address - Street 1:1401 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-3023
Practice Address - Country:US
Practice Address - Phone:518-381-9202
Practice Address - Fax:518-381-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001235-1174400000X
NY009758-1174400000X
NY237138-1174400000X
NY095150-1174400000X
NY088151-1174400000X
NY256386-1174400000X
174400000X
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00381902Medicaid
NY01277903Medicaid
NY00373340Medicaid
NY03158770Medicaid
NY02626048Medicaid
NY02626048Medicaid
NYB82018Medicare UPIN
Q27758Medicare UPIN
NY03158770Medicaid