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General NPI Number Information
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NPI Number | 1700073731
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Entity Type | Organization
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Legal Business Name | ALL NEUROLOGICAL SERVICES PC
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 596 ANDERSON AVE
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City | CLIFFSIDE PARK
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State | NJ
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Zip | 07010-1831
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Country | US
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Telephone | 201-943-6464
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Fax | 201-943-2206
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Provider Business Mailing Address
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Address Line | 1041 ARCADIAN WAY
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City | FORT LEE
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State | NJ
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Zip | 07024-6349
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Country | US
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Telephone | 201-943-6464
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Fax | 201-943-2206
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Authorized Official
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Title or Position | PRESIDENT
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Name | IGOR KHELEMSKY
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Credential | MD
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Telephone | 718-943-6464
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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 | 196963
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License Number State | NY
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