NORTHEAST NEUROSURGERY LLC (NPI# 1124071709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124071709 |
| Entity Type | Organization |
| Organization Name | NORTHEAST NEUROSURGERY LLC |
| Practice Address |
63 Shaker Rd Suite 201 Albany NY 12204-1030 |
| Practice Telephone | 5184461850 |
| Practice Fax Number | 5184461861 |
| Mailing Telephone | 5184461850 |
| Mailing Fax Number | 5184461861 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DEBORAH HRUSTICH (PRESIDENT) |
| Authorized Official Telephone | 5184461850 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
63 SHAKER RD SUITE 201 |
| City | ALBANY |
| State | NY |
| Zip Code | 12204-1030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518960541 | Sangbock Kim | Physical Medicine & Rehabilitation | 63 Shaker Rd, Ste 104, Albany, NY 12204-1030 | 2005-05-23 |
| 1366975831 | Dow Behavioral Health Medical PC | Psychiatry & Neurology | 63 Shaker Rd, Suite G05, Albany, NY 12204-1025 | 2017-04-11 |
| 1104276294 | Jessica Riggins | Nurse Practitioner | 63 Shaker Rd, Suite 201, Albany, NY 12204-1025 | 2016-06-20 |
| 1962815696 | St. Peter's Health Partners Medical Associates, P.C. | Nurse Practitioner | 63 Shaker Rd, Suite 201, Albany, NY 12204-1030 | 2014-06-10 |
| 1932475985 | Albany Surgery Associates,pc | Surgery | 63 Shaker Rd, Ste#203, Albany, NY 12204-1030 | 2012-03-23 |
| 1497054498 | Capital District Interventional Spine & Rehabilitation, Pllc | Physical Medicine & Rehabilitation | 63 Shaker Rd, Albany, NY 12204-1030 | 2011-03-17 |
| 1942501663 | Ana Maria Kausel | Internal Medicine | 63 Shaker Rd, Suite 201, Albany, NY 12204-1030 | 2010-11-11 |
| 1396050613 | James E. Striker Md Pllc | Orthopaedic Surgery | 63 Shaker Rd, Suite G05, Albany, NY 12204-1030 | 2010-08-11 |
| 1538481965 | Susan Sunjung Kim I | Internal Medicine | 63 Shaker Rd, Suite 201, Albany, NY 12204-1030 | 2010-02-26 |
| 1346424397 | Anna Yermakova Allen | Ophthalmology | 63 Shaker Rd, Suite 101, Albany, NY 12204-1030 | 2007-12-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568015352 | Chanel Bovian | Licensed Practical Nurse | 587 Broadway Apt.a2, Menands, NY 12204 | 2019-07-20 |
| 1659853513 | David Jonathan Brown | Driver | 456 North Pearl St., Albany, NY 12204 | 2018-09-06 |
| 1255686481 | Adam Michael Burman | Pharmacist | 350 Northern Boulevard, Albany, NY 12204 | 2012-07-13 |
| 1043579196 | Victoria Epstein | Ophthalmology | 63 Shaker Rd Ste 101, Albany, NY 12204 | 2012-05-10 |
| 1306117270 | Jacqueline J Swenson | Physical Therapist | Albany Memorial Hospital, 600 Northern Blvd, Albany, NY 12204 | 2012-01-24 |
| 1730466681 | Kathleen C Dalcol | Registered Nurse | 570 North Pearl Street, North Albany Academy, Albany, NY 12204 | 2011-11-07 |
| 1649592049 | Shirley L Savage | Licensed Practical Nurse | 150 Broadway Ave., Suite 310, Menands, NY 12204 | 2010-02-26 |
| 1801084645 | The Embryology Network | Clinical Medical Laboratory | 600 Northern Blvd., Albany Memorial Hospital, Albany, NY 12204 | 2007-10-05 |
| 1124248430 | Prime Care Physicians, P.l.l.c. | Internal Medicine | 63 Albany Shaker Road, Suite 102, Albany, NY 12204 | 2007-04-27 |
| 1578788204 | Antoinette June Holman | Licensed Practical Nurse | Riverview Center 150 Broadway, Suite 6e, Albany, NY 12204 | 2007-04-16 |
| Find all providers in zip 12204 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508132390 | Ahmed Meleis | Neurological Surgery | 391 Myrtle Ave # Mc-55, Albany, NY 12208-3835 | 2012-03-27 |
| 1205829009 | Kimberly S Brown | Neurological Surgery | 2622 Meredyth Dr, Albany, GA 31707-0206 | 2005-08-26 |
| 1912522202 | Amir Hadanny | Neurological Surgery | 47 New Scotland Ave, Neurosurgery Department, Albany, NY 12208 | 2020-06-11 |
| 1821542390 | Amr Albakry | Neurological Surgery | 47 New Scotland Ave, Mc10, Albany, NY 12208-3412 | 2016-08-12 |
| 1467801332 | Albany Medical College | Neurological Surgery | 391 Myrtle Ave, Suite 1b, Albany, NY 12208-3513 | 2016-06-10 |
| 1306104468 | Alexander Richard Riccio | Neurological Surgery | 47 New Scotland Ave, Department of Neurosurgery, Albany, NY 12208-3412 | 2012-04-26 |
| 1467775734 | Palmyra Brain & Spine Center, LLC | Neurological Surgery | 2002 Palmyra Rd, Suite 202, Albany, GA 31701-1591 | 2010-03-01 |
| 1346492469 | Donald Dewey Davis | Neurological Surgery | 4 Airline Dr, Albany, NY 12205-1023 | 2008-10-21 |
| 1245490283 | John Charles Dalfino Jr. | Neurological Surgery | 43 New Scotland Ave, Mail Code 10, Albany, NY 12208-3412 | 2008-06-12 |
| 1538375076 | Adrian Mzee Smith | Neurological Surgery | 2622 Meredyth Dr, Albany, GA 31707-0206 | 2007-05-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.