Provider Demographics
NPI:1538331749
Name:AUTONOMIC NEUROLOGY, PLLC
Entity Type:Organization
Organization Name:AUTONOMIC NEUROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-635-5247
Mailing Address - Street 1:2 CHARLTON ST
Mailing Address - Street 2:15B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4909
Mailing Address - Country:US
Mailing Address - Phone:347-635-5247
Mailing Address - Fax:212-671-1466
Practice Address - Street 1:2 CHARLTON ST
Practice Address - Street 2:15B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-4909
Practice Address - Country:US
Practice Address - Phone:347-635-5247
Practice Address - Fax:212-671-1466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2293372084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty