Long Island Neurological, PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

220993 Issued in NY

Legal business name

LONG ISLAND NEUROLOGICAL, PC

Practice address

363 Route 111. Suite #102
Smithtown, NY 11787-4756

Phone

(631) 780-6804

Fax

(631) 780-6806

NPI assigned

May 25, 2006

Last updated

Jan 19, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samir Haddad

Title

President

Phone

(631) 780-6804

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1780630657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111. SUITE #102",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874756",
            "telephone_number": "631-738-8300",
            "fax_number": "631-738-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111. SUITE #102",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874756",
            "telephone_number": "631-780-6804",
            "fax_number": "631-780-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND NEUROLOGICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "HADDAD",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-780-6804"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "220993",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016755",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Smithtown, NY
• Providers in Smithtown, 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 19, 2012; 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.