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General NPI Number Information
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NPI Number | 1235208406
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Entity Type | Organization
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Legal Business Name | CNY NEUROLOGICAL CONSULTING PLLC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 5000 BRITTONFIELD PKWY A116
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City | EAST SYRACUSE
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State | NY
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Zip | 13057
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Country | US
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Telephone | 315-634-5550
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Fax | 315-634-5553
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Provider Business Mailing Address
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Address Line | 5000 BRITTONFIELD PARKWAY SUITE A116
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City | EAST SYRACUSE
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State | NY
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Zip | 13057
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Country | US
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Telephone | 315-634-5550
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Fax | 315-795-2125
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Authorized Official
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Title or Position | OWNER
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Name | MR. HASSAN SHUKRI
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Credential | MD
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Telephone | 315-634-5550
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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 | 195245
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License Number State |
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