Organization Active NPI

Complex Spine and Neurological Surgery PC

  • Neurological Surgery Physician
  • New Rochelle, NY
National Provider Identifier
1255353157
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
199196 Issued in NY
Legal business name
COMPLEX SPINE AND NEUROLOGICAL SURGERY PC
Practice address
421 Huguenot St
New Rochelle, NY 10801-7004
Phone
(914) 235-3526
Fax
(914) 771-7339
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amed Rawanduzy, MDNPI 1356371009
Title
MD
Phone
(914) 771-7335

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 199196 NY Primary

Addresses

Primary practice location

421 Huguenot St
New Rochelle, NY 10801-7004

Mailing address

PO Box 1240
Scarsdale, NY 10583-9240
Phone (914) 771-7335

Other identifiers 1

IdentifierTypeStateIssuer
01710287MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1255353157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1240",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105839240",
            "telephone_number": "914-771-7335",
            "fax_number": "914-771-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 HUGUENOT ST",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108017004",
            "telephone_number": "914-235-3526",
            "fax_number": "914-771-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLEX SPINE AND NEUROLOGICAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "RAWANDUZY",
        "authorized_official_first_name": "AMED",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "914-771-7335",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "199196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01710287",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.