Organization
SUFFOLK NEUROLOGY & NEUROPHYSIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURANGANEE MARY DE LANEROLLE M.D. (PRESIDENT)
(631) 246-5454
Entity
Organization
Contact information
Practice address
2500 NESCONSET HWY, SUITE 16A, STONY BROOK, NY 11790-2555
(631) 246-5454
(631) 246-5902
Mailing address
2500 NESCONSET HWY, SUITE 16A, STONY BROOK, NY 11790-2555
(631) 246-5454
(631) 246-5902
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084N0400X
Neurology Physician
Primary
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
Other
Enumeration date
10/24/2008
Last updated
10/24/2008
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