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General NPI Number Information
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NPI Number | 1720171374
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Entity Type | Organization
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Legal Business Name | NORHERN BOULEVARD NEUROLOGICAL SURGERY, P.C.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 600 NORTHERN BOULEVARD SUITE 117
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City | GREAT NECK
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State | NY
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Zip | 11021
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Country | US
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Telephone | 516-478-0004
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Fax |
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Provider Business Mailing Address
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Address Line | 600 NORTHERN BOULEVARD SUITE 117
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City | GREAT NECK
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State | NY
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Zip | 11021
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Country | US
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Telephone | 516-478-0004
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Fax |
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Authorized Official
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Title or Position | BILLING/CLAIMS MANAGER
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Name | MS. ZORINA R THOMAS-JACKSON
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Credential | CPC
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Telephone | 516-255-6228
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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 |
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License Number State |
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