Healthcare Provider Details

I. General information

NPI: 1881711596
Provider Name (Legal Business Name): ALL NEUROLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 65TH ST STE 1
BROOKLYN NY
11204-4089
US

IV. Provider business mailing address

2310 65 STREET 1 FLOOR
BROOKLYN NY
11204
US

V. Phone/Fax

Practice location:
  • Phone: 718-376-3200
  • Fax:
Mailing address:
  • Phone: 718-376-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number196963
License Number StateNY

VIII. Authorized Official

Name: DR. IGOR KHELEMSKY
Title or Position: PRESIDENT
Credential:
Phone: 718-376-3200