Provider Demographics
NPI:1811047616
Name:NY NEUROSCIENCE ASSOCIATE, PC
Entity type:Organization
Organization Name:NY NEUROSCIENCE ASSOCIATE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMSHID
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAJAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:212-746-2396
Mailing Address - Street 1:210 LAFAYETTE ST APT 10A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-4018
Mailing Address - Country:US
Mailing Address - Phone:212-746-2396
Mailing Address - Fax:212-772-0357
Practice Address - Street 1:JAMAICA HOSPITAL 8900 VAN WYCK EXPRESSWAY, JAMAICA, NY
Practice Address - Street 2:NEW YORK PRESBYTERIAN HOSPITAL 525 EAST 68TH STREET
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-746-2396
Practice Address - Fax:212-772-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01033738Medicaid
NYA98223Medicare UPIN
NY05E401Medicare ID - Type Unspecified