Provider Demographics
NPI:1942500715
Name:THE BRAIN SPECIALISTS, LLC
Entity Type:Organization
Organization Name:THE BRAIN SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MIHAILA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:347-994-8855
Mailing Address - Street 1:1010 NORTHERN BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5317
Mailing Address - Country:US
Mailing Address - Phone:347-884-9955
Mailing Address - Fax:
Practice Address - Street 1:1010 NORTHERN BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5317
Practice Address - Country:US
Practice Address - Phone:347-884-9955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017224261QH0100X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health