Healthcare Provider Details

I. General information

NPI: 1144961863
Provider Name (Legal Business Name): SYNAPSE MEDICAL CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 60TH ST APT P2
WOODSIDE NY
11377-2119
US

IV. Provider business mailing address

3443 60TH ST APT P2
WOODSIDE NY
11377-2119
US

V. Phone/Fax

Practice location:
  • Phone: 201-730-2743
  • Fax: 239-235-4641
Mailing address:
  • Phone: 201-730-2743
  • Fax: 239-235-4641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KAZI MD ASIF HILMI
Title or Position: DIRECTOR
Credential: MD
Phone: 929-372-4835