Provider Demographics
NPI:1013374511
Name:COGNITIVE NEUROLOGY CONSULTANTS, P.A., P.C.
Entity type:Organization
Organization Name:COGNITIVE NEUROLOGY CONSULTANTS, P.A., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALON
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIFAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-620-3204
Mailing Address - Street 1:747 W 231ST ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1003
Mailing Address - Country:US
Mailing Address - Phone:786-620-3204
Mailing Address - Fax:954-840-8254
Practice Address - Street 1:18 E 41ST ST FL 14
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6244
Practice Address - Country:US
Practice Address - Phone:305-395-4313
Practice Address - Fax:954-840-8254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1300X
FLME1225092084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03918792Medicaid