Organization
LONG ISLAND NEUROLOGICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIR HADDAD (PRESIDENT)
(631) 780-6804
Entity
Organization
Contact information
Practice address
363 ROUTE 111. SUITE #102, SMITHTOWN, NY 11787-4756
(631) 780-6804
(631) 780-6806
Mailing address
363 ROUTE 111. SUITE #102, SMITHTOWN, NY 11787-4756
(631) 738-8300
(631) 738-8500
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
220993
NY
225100000X
Physical Therapist
016755
NY
Other
Enumeration date
05/25/2006
Last updated
01/19/2012
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