Cny Neurodiagnostics PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

266512 Issued in NY

Legal business name

CNY NEURODIAGNOSTICS PLLC

Practice address

1101 Erie Blvd E
Syracuse, NY 13210-1148

Phone

(315) 481-8777

Fax

(315) 782-8699

NPI assigned

Jan 27, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Samah Omer Mohiuddin, M.D.NPI 1336455112

Title

Owner

Phone

(315) 481-8777

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Health First Diagnostics LLC

  • Neurology Physician
  • Margate, FL
  • NPI 1396353298

  Member Of

  NPD member

Locations

Practitioners 2

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

• Samah O Mohiuddin, MD

  • Neurology Physician
  • Watertown, NY
  • NPI 1336455112
  Medicare reassignment NPD Authorized official
• Sayeeda Taj Mohiuddin, MD, FACOG

  • Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
  • Syracuse, NY
  • NPI 1235348996
  NPD (past)

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1619367885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 FACTORY ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012729",
            "telephone_number": "315-782-4207",
            "fax_number": "315-786-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 ERIE BLVD E",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101148",
            "telephone_number": "315-481-8777",
            "fax_number": "315-782-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CNY NEURODIAGNOSTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "MOHIUDDIN",
        "authorized_official_first_name": "SAMAH",
        "authorized_official_middle_name": "OMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-481-8777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "266512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; 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.