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General NPI Number Information
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NPI Number | 1174103170
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Entity Type | Organization
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Legal Business Name | NEUROTEST OF NEW YORK MEDICAL PLLC
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 245 5TH AVE FL 3
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City | NEW YORK
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State | NY
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Zip | 10016-8728
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Country | US
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Telephone | 212-547-0738
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Fax | 872-241-0322
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Provider Business Mailing Address
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Address Line | 909 3RD AVE UNIT 6768
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City | NEW YORK
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State | NY
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Zip | 10150-2082
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Country | US
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Telephone | 212-547-0738
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Fax | 872-241-0322
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Authorized Official
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Title or Position | EMPLOYER
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Name | THOMAS HOANG
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Credential | MD
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Telephone | 212-547-0738
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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 |
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License Number State |
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