RTJ Enterprise Neurology PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

RTJ ENTERPRISE NEUROLOGY PLLC

Doing business as

BREA Stroke Center

Practice address

7 Southside Dr Ste 206
Clifton Park, NY 12065-3894

Phone

(518) 709-0005

Fax

(518) 980-4132

NPI assigned

May 2, 2024

Organization subpart

Yes

Parent organization

RTJ ENTERPRISE NEUROLOGY PLLCAs reported in NPPES

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

Authorized official

Name

Shellie Liebig

Title

Practice Manager

Phone

(518) 709-0005

Specialties & licenses 1

Addresses

Other names 1

• BREA Stroke Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Part of

RTJ Enterprise Neurology PL

Practitioners 2

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

• Richard Thomas Cleary Jackson, MD

  • Neurology Physician
  • Glens Falls, NY
  • NPI 1932427218
  Medicare reassignment Care Compare group NPD
• William Frances Owens, PA

  • Surgical Physician Assistant
  • Latham, NY
  • NPI 1427076652
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1912754599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SOUTHSIDE DR STE 206",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653894",
            "telephone_number": "518-709-0005",
            "fax_number": "518-980-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SOUTHSIDE DR STE 206",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653894",
            "telephone_number": "518-709-0005",
            "fax_number": "518-980-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RTJ ENTERPRISE NEUROLOGY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RTJ ENTERPRISE NEUROLOGY PLLC",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "LIEBIG",
        "authorized_official_first_name": "SHELLIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "518-709-0005"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BREA Stroke Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly L Romani
• Ronald Otwori NP in Psychiatry PLLC
• Ericka Rose, MHC
• Amanda Rosenbrock, PHARMD
• Kimberly Rothwell, PT
• Joseph Y Rudnick, MD
• Rugani Family Chiropractic, P.C.
• Sharon Ann Russell-Chase
• Therese Eileen Russo, MA
• Debra Aleine Rutledge, PT

• Neurology Physician in Clifton Park, NY
• Providers in Clifton Park, 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 May 2, 2024; 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.