Provider Demographics
NPI:1598028052
Name:A S NEUROLOGY PC
Entity Type:Organization
Organization Name:A S NEUROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHATLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-266-2078
Mailing Address - Street 1:210 OLD CAMPION RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1641
Mailing Address - Country:US
Mailing Address - Phone:315-266-2078
Mailing Address - Fax:
Practice Address - Street 1:210 OLD CAMPION RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1641
Practice Address - Country:US
Practice Address - Phone:315-266-2078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2142562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty