Organization
ADULT AND CHILD NEUROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAJA ILIC MD (MEDICAL DIRECTOR)
(914) 358-1162
Entity
Organization
Contact information
Practice address
3613 30TH AVE, ASTORIA, NY 11103-4329
(800) 200-8196
(914) 368-8343
Mailing address
21 KINGSTON RD, SCARSDALE, NY 10583-1147
(914) 358-1162
(914) 368-8343
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
Other
Enumeration date
05/22/2019
Last updated
09/01/2023
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