Organization
EAST GREENBUSH NEUROLOGY OFFICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HANI MIDANI MD (SOLE PROPIETOR)
(518) 694-3053
Entity
Organization
Contact information
Practice address
1528 COLUMBIA TPKE, CASTLETON, NY 12033-9584
(518) 694-3053
(518) 694-3056
Mailing address
1528 COLUMBIA TPKE, CASTLETON, NY 12033-9584
(518) 694-3053
(518) 694-3056
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
214014
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01954374
—
NY
01
—
BB5753
MEDICARE ID-TYPE UNSPECIFIED
NY
Enumeration date
06/18/2009
Last updated
07/28/2017
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