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General NPI Number Information
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NPI Number | 1306800057
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Entity Type | Organization
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Legal Business Name | REGIONAL NEUROLOGICAL ASSOCIATES, PC
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | 4234 BRONX BLVD FRNT 1
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City | BRONX
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State | NY
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Zip | 10466-2669
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Country | US
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Telephone | 718-515-4347
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Fax | 718-653-8641
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Provider Business Mailing Address
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Address Line | 4234-1 BRONX BOULEVARD
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City | BRONX
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State | NY
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Zip | 10466-2801
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Country | US
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Telephone | 718-515-4347
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Fax | 718-653-8641
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KAMRAN TABADDOR
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Credential | MD
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Telephone | 718-655-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 195905
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License Number State | NY
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