Provider Demographics
NPI:1942394473
Name:GREAT NECK NEUROLOGICAL SURGERY, P.C.
Entity Type:Organization
Organization Name:GREAT NECK NEUROLOGICAL SURGERY, P.C.
Other - Org Name:GREAT NECK STAND UP MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING/CLAIMS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ZORINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:THOMAS-JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:516-255-6228
Mailing Address - Street 1:600 NORTHERN BOULEVARD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:516-478-0005
Mailing Address - Fax:
Practice Address - Street 1:600 NORTHERN BOULEVARD
Practice Address - Street 2:SUITE 117
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021
Practice Address - Country:US
Practice Address - Phone:516-478-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty