Provider Demographics
NPI:1356168223
Name:EMPIRE NEUROSURGERY, PLLC
Entity type:Organization
Organization Name:EMPIRE NEUROSURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-488-8868
Mailing Address - Street 1:1177 HIGH RIDGE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1221
Mailing Address - Country:US
Mailing Address - Phone:203-747-8688
Mailing Address - Fax:914-303-6435
Practice Address - Street 1:970 N BROADWAY STE 204
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1310
Practice Address - Country:US
Practice Address - Phone:914-303-6548
Practice Address - Fax:914-303-6435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty