Provider Demographics
NPI:1760806681
Name:NEUROLOGY PAIN CARE, PC
Entity Type:Organization
Organization Name:NEUROLOGY PAIN CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ORMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-945-5436
Mailing Address - Street 1:6818 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5803
Mailing Address - Country:US
Mailing Address - Phone:718-932-2004
Mailing Address - Fax:718-932-2005
Practice Address - Street 1:6818 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5803
Practice Address - Country:US
Practice Address - Phone:718-932-2004
Practice Address - Fax:718-932-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2431882084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty