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General NPI Number Information
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NPI Number | 1427245075
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Entity Type | Organization
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Legal Business Name | ADVANCED NEUROLOGICAL CARE P.C.
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 23 LANGDON PL
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City | LYNBROOK
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State | NY
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Zip | 11563-2414
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Country | US
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Telephone | 516-374-4451
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 209
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City | HEWLETT
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State | NY
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Zip | 11557-0209
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Country | US
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Telephone | 516-374-4451
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Fax | 516-374-1987
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. KERIN BELLER HAUSKNECHT
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Credential | M.D.
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Telephone | 516-374-4451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 202181
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License Number State | NY
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