Provider Demographics
NPI:1790095289
Name:DGS NEUROLOGICAL PLLC
Entity Type:Organization
Organization Name:DGS NEUROLOGICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERALDI-SAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-581-3390
Mailing Address - Street 1:1705 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-2817
Mailing Address - Country:US
Mailing Address - Phone:877-581-3390
Mailing Address - Fax:
Practice Address - Street 1:4982 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6399
Practice Address - Country:US
Practice Address - Phone:877-581-3390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2405182084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty