Provider Demographics
NPI:1689109035
Name:PRECISION NEUROLOGICAL CARE PLLC
Entity Type:Organization
Organization Name:PRECISION NEUROLOGICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH MINTU
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-500-1031
Mailing Address - Street 1:31 GARDNER AVE
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-2552
Mailing Address - Country:US
Mailing Address - Phone:516-500-1031
Mailing Address - Fax:
Practice Address - Street 1:31 GARDNER AVE
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2552
Practice Address - Country:US
Practice Address - Phone:516-500-1031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2525361405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty