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Organization

BROOKHAVEN NEUROLOGY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PINA PATEL-PULIPATI MD (DIRECTOR)
(631) 654-2386
Entity
Organization

Contact information

Practice address
74 SOUTHAVEN AVE, SUITE G, MEDFORD, NY 11763-3746
(631) 654-2386
(631) 447-3852
Mailing address
74 SOUTHAVEN AVE, SUITE G, MEDFORD, NY 11763-3746
(631) 654-2386
(631) 447-3852

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
266254
NY
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
266254
NY

Other

Enumeration date
08/14/2013
Last updated
08/14/2013
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