Provider Demographics
NPI:1851454110
Name:NASSAU NEUROLOGICAL CONSULTANTS, P.C.
Entity Type:Organization
Organization Name:NASSAU NEUROLOGICAL CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SAVELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-294-9750
Mailing Address - Street 1:156 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4084
Mailing Address - Country:US
Mailing Address - Phone:516-294-9750
Mailing Address - Fax:516-294-5800
Practice Address - Street 1:156 1ST ST
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4084
Practice Address - Country:US
Practice Address - Phone:516-294-9750
Practice Address - Fax:516-294-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1340082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW04701Medicare ID - Type Unspecified