NPIMap

Organization Active NPI

Neurological Specialties of Long Island, PLLC

  • Neurological Surgery Physician
  • Great Neck, NY
National Provider Identifier
1407856933
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
NEUROLOGICAL SPECIALTIES OF LONG ISLAND, PLLC
Practice address
170 Great Neck Rd
Great Neck, NY 11021-3337
Phone
(516) 487-4464
Fax
(516) 487-4950
NPI assigned
Jul 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Itzhak Haimovic, MDNPI 1629075767
Title
Partner
Phone
(516) 773-0089

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 NY Primary

Addresses

Primary practice location

170 Great Neck Rd
Great Neck, NY 11021-3337

Mailing address

170 Great Neck Rd
Great Neck, NY 11021-3337
Phone (516) 487-4464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050706000617 NY Part B Supplier - Clinic/Group Practice 1052201381 Receives reassigned benefits from 10 practitioners
Practice locations: Great Neck, NY; Mill Neck, NY; Lawrence, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1407856933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 GREAT NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213337",
            "telephone_number": "516-487-4464",
            "fax_number": "516-487-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 GREAT NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213337",
            "telephone_number": "516-487-4464",
            "fax_number": "516-487-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL SPECIALTIES OF LONG ISLAND, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HAIMOVIC",
        "authorized_official_first_name": "ITZHAK",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "516-773-0089",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.