MEDICARE: NY NEUROCARE MEDICAL SERVICES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1124630215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NY NEUROCARE MEDICAL SERVICES, PLLC

Provider Business Mailing Address
First Line	:	8321 20TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3001
Country	:	US
Telephone Number	:	718-996-9888
Fax Number	:	718-996-2888

Provider Business Practice Location Address
First Line	:	8321 20TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3001
Country	:	US
Telephone Number	:	718-996-9888
Fax Number	:	718-996-2888

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FLORENCE SHUM
Credential	:	DO
Telephone Number	:	718-996-9888

Provider Enumeration Date	:	08/19/2020
Last Update Date	:	08/19/2020

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