Healthcare Provider Details

I. General information

NPI: 1356651202
Provider Name (Legal Business Name): DEPARTMENT OF NEUROSURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 03/09/2025
Certification Date: 03/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 STONELEIGH AVE STE 118
CARMEL NY
10512-2458
US

IV. Provider business mailing address

667 STONELEIGH AVE STE 118
CARMEL NY
10512-2458
US

V. Phone/Fax

Practice location:
  • Phone: 845-244-0488
  • Fax: 866-981-5080
Mailing address:
  • Phone: 845-244-0488
  • Fax: 866-981-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: P. CHARLES GARELL
Title or Position: OWNER
Credential:
Phone: 845-244-0488