Provider Demographics
NPI:1396922498
Name:CENTRAL PARK NEUROSURGERY
Entity type:Organization
Organization Name:CENTRAL PARK NEUROSURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROSURGEON PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NARAYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDARESAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-876-7575
Mailing Address - Street 1:1148 FIFTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0807
Mailing Address - Country:US
Mailing Address - Phone:212-876-7575
Mailing Address - Fax:212-876-1896
Practice Address - Street 1:1148 FIFTH AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0807
Practice Address - Country:US
Practice Address - Phone:212-876-7575
Practice Address - Fax:212-876-1896
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL PARK NEUROSURGERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1331101207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty