Provider Demographics
NPI:1619115979
Name:KINGS NEUROLOGY, PC
Entity Type:Organization
Organization Name:KINGS NEUROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-283-6430
Mailing Address - Street 1:2044 OCEAN AVE. SUITE A10
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230
Mailing Address - Country:US
Mailing Address - Phone:718-677-0009
Mailing Address - Fax:718-677-9577
Practice Address - Street 1:3131 KINGS HWY STE C7
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2643
Practice Address - Country:US
Practice Address - Phone:718-677-0009
Practice Address - Fax:718-677-9577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-25
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1293602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty