Organization
DIAGNOSTIC NEUROLIGICAL TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MORMINO M.D. (OWNER)
(718) 524-0500
Entity
Organization
Contact information
Practice address
945 HUGUENOT AVE, STATEN ISLAND, NY 10312-4312
(718) 524-0500
Mailing address
90 MILLS AVE, STATEN ISLAND, NY 10305-4524
(718) 524-0500
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
101545
NY
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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