Provider Demographics
NPI:1962452326
Name:NEW YORK NEUROSURGERY & NEUROSCIENCE ASSOCIATES
Entity Type:Organization
Organization Name:NEW YORK NEUROSURGERY & NEUROSCIENCE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROSURGEON, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:CORNACCHIA
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:516-255-0350
Mailing Address - Street 1:2000 N VILLAGE AVE
Mailing Address - Street 2:STE 403
Mailing Address - City:ROCKVILLE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1078
Mailing Address - Country:US
Mailing Address - Phone:516-255-0350
Mailing Address - Fax:516-678-1421
Practice Address - Street 1:110 OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:POINT LOOKOUT
Practice Address - State:NY
Practice Address - Zip Code:11569-3029
Practice Address - Country:US
Practice Address - Phone:516-255-0350
Practice Address - Fax:516-738-4746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007844-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty