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General NPI Number Information
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NPI Number | 1073785143
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Entity Type | Organization
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Legal Business Name | FIFTH AVENUE NEUROLOGY, PLLC
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Dates
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Enumeration Date | 03/29/2008
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Last Update Date | 03/29/2008
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Provider Practice Location Address
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Address Line | 80 5TH AVE SUITE 1605
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City | NEW YORK
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State | NY
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Zip | 10011-8002
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Country | US
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Telephone | 212-675-3878
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Fax | 212-647-1931
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Provider Business Mailing Address
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Address Line | 80 5TH AVE SUITE 1605
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City | NEW YORK
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State | NY
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Zip | 10011-8002
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Country | US
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Telephone | 212-675-3878
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Fax | 212-647-1931
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLAUDE MACALUSO
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Credential | M.D.
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Telephone | 212-675-3878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 163336
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License Number State | NY
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