Basic Information
| Provider Information | |||||||||
| NPI: | 1235208406 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CNY NEUROLOGICAL CONSULTING PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 BRITTONFIELD PARKWAY | ||||||||
| Address2: | SUITE A116 | ||||||||
| City: | EAST SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3156345550 | ||||||||
| FaxNumber: | 3157952125 | ||||||||
| Practice Location | |||||||||
| Address1: | 5000 BRITTONFIELD PKWY | ||||||||
| Address2: | A116 | ||||||||
| City: | EAST SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3156345550 | ||||||||
| FaxNumber: | 3156345553 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2006 | ||||||||
| LastUpdateDate: | 05/23/2013 | ||||||||
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| AuthorizedOfficialLastName: | SHUKRI | ||||||||
| AuthorizedOfficialFirstName: | HASSAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3156345550 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 195245 | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.