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General NPI Number Information
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NPI Number | 1891864856
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Entity Type | Organization
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Legal Business Name | DIX HILLS NEUROLOGICAL SERVICES, P.C.
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 24 CANDLEWOOD PATH
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City | DIX HILLS
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State | NY
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Zip | 11746-5304
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Country | US
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Telephone | 347-247-3836
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Fax |
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Provider Business Mailing Address
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Address Line | 24 CANDLEWOOD PATH
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City | DIX HILLS
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State | NY
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Zip | 11746-5304
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Country | US
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Telephone | 347-247-3836
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHICONG YE
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Credential | MD
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Telephone | 347-247-3836
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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 | 218322
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License Number State | NY
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