Provider Demographics
NPI:1700017803
Name:NEUROLOGY CONTINUUM PC
Entity Type:Organization
Organization Name:NEUROLOGY CONTINUUM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:BROSGOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-648-4567
Mailing Address - Street 1:30 W END AVE
Mailing Address - Street 2:BLDG.1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4800
Mailing Address - Country:US
Mailing Address - Phone:718-648-4567
Mailing Address - Fax:718-648-0407
Practice Address - Street 1:30 W END AVE
Practice Address - Street 2:BLDG.1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4800
Practice Address - Country:US
Practice Address - Phone:718-648-4567
Practice Address - Fax:718-648-0407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197230174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01659329Medicaid
NY01659329Medicaid