Provider Demographics
NPI:1659797488
Name:MANHATTAN NEUROSURGERY PC
Entity Type:Organization
Organization Name:MANHATTAN NEUROSURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-600-4879
Mailing Address - Street 1:1 W 85TH ST
Mailing Address - Street 2:APT 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4134
Mailing Address - Country:US
Mailing Address - Phone:212-600-4879
Mailing Address - Fax:212-496-8548
Practice Address - Street 1:1 W 85TH ST
Practice Address - Street 2:APT 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4134
Practice Address - Country:US
Practice Address - Phone:212-600-4879
Practice Address - Fax:212-496-8548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154813207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty