Provider Demographics
NPI:1336185313
Name:NEUROLOGY GROUP, PLLC
Entity Type:Organization
Organization Name:NEUROLOGY GROUP, PLLC
Other - Org Name:YAN LUPYAN, VLADIMIR ZLATNIK
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUPYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-232-1022
Mailing Address - Street 1:7620 BAY PKWY STE 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1516
Mailing Address - Country:US
Mailing Address - Phone:718-232-1022
Mailing Address - Fax:718-232-1014
Practice Address - Street 1:7620 BAY PKWY STE 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-1516
Practice Address - Country:US
Practice Address - Phone:718-232-1022
Practice Address - Fax:718-232-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1967302084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1336185313OtherNPI 1336185313
NY29M087Z501Medicare PIN
NYF99595Medicare UPIN
NY101157Z501Medicare PIN