Provider Demographics
NPI:1497479794
Name:NEUROLOGY MIND CARE PLLC
Entity Type:Organization
Organization Name:NEUROLOGY MIND CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIEL
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:DEUTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-636-3873
Mailing Address - Street 1:1955 MERRICK RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4635
Mailing Address - Country:US
Mailing Address - Phone:516-636-3873
Mailing Address - Fax:516-210-2616
Practice Address - Street 1:1955 MERRICK RD STE 204
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4635
Practice Address - Country:US
Practice Address - Phone:516-636-3873
Practice Address - Fax:516-210-2616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty