Brookhaven Neurology PLLC

Organization Active NPI Neurology Physician · Medford, NY

NPI 1083047971 · NPPES record last updated Aug 14, 2013

Key facts

NPI
1083047971
Entity type
Organization (NPI type 2)
Primary specialty
Neurology Physician 2084N0400X
License
266254 (NY)
Legal business name
BROOKHAVEN NEUROLOGY PLLC
Practice address
74 Southaven Ave
Suite G
Medford, NY 11763-3746
Phone
(631) 654-2386
Fax
(631) 447-3852
NPI assigned
Aug 14, 2013
Organization subpart
No

Authorized official

Name
Dr. Pina Patel-Pulipati, MD
Title
Director
Phone
(631) 654-2386

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

74 Southaven Ave
#G
Medford, NY 11763
Phone (631) 654-2386

74 Southaven Ave
Ste G
Medford, NY 11763
Phone (631) 654-2386

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084N0400X 266254 NY Yes
Neurology with Special Qualifications in Child Neurology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084N0402X 266254 NY

Addresses

Primary practice location

74 Southaven Ave
Suite G
Medford, NY 11763-3746

Mailing address

74 Southaven Ave
Suite G
Medford, NY 11763-3746
Phone (631) 654-2386

Other providers in Medford, NY

All providers in Medford, NY · Neurology Physician in New York

Sources for this page

Verify at the official NPI Registry.