Provider Demographics
NPI:1881661403
Name:METROPOLITAN NEUROSURGERY ASSOCIATES, PC
Entity Type:Organization
Organization Name:METROPOLITAN NEUROSURGERY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-569-7737
Mailing Address - Street 1:309 ENGLE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1824
Mailing Address - Country:US
Mailing Address - Phone:201-569-7737
Mailing Address - Fax:201-373-2041
Practice Address - Street 1:309 ENGLE ST
Practice Address - Street 2:SUITE 6
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1824
Practice Address - Country:US
Practice Address - Phone:201-569-7737
Practice Address - Fax:201-569-1494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ579823Medicare ID - Type Unspecified
NYW19021Medicare ID - Type Unspecified