Provider Demographics
NPI:1568758621
Name:CENTRAL QUEENS NEUROLOGY, PLLC
Entity Type:Organization
Organization Name:CENTRAL QUEENS NEUROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-952-8464
Mailing Address - Street 1:9801 67TH AVE
Mailing Address - Street 2:APT. 6C
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4967
Mailing Address - Country:US
Mailing Address - Phone:917-952-2464
Mailing Address - Fax:
Practice Address - Street 1:9801 67TH AVE
Practice Address - Street 2:APT. 6C
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4967
Practice Address - Country:US
Practice Address - Phone:917-952-2464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1942622084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty