Provider Demographics
NPI:1518396308
Name:NEW YORK NEUROLOGY AND MEDICAL SERVICES P.C
Entity Type:Organization
Organization Name:NEW YORK NEUROLOGY AND MEDICAL SERVICES P.C
Other - Org Name:NEW YORK NEUROLOGY & PAIN MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SURASKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-487-9414
Mailing Address - Street 1:15 BARSTOW RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2211
Mailing Address - Country:US
Mailing Address - Phone:516-487-9414
Mailing Address - Fax:516-487-2302
Practice Address - Street 1:15 BARSTOW RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2211
Practice Address - Country:US
Practice Address - Phone:516-487-9414
Practice Address - Fax:516-487-2302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002823111NN0400X
NY2609692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty