MAIN STREET MEDICAL, P.C. - NEUROLOGY (NPI# 1407810385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407810385 |
| Entity Type | Organization |
| Organization Name | MAIN STREET MEDICAL, P.C. - NEUROLOGY |
| Practice Address |
5645 Main St Flushing NY 11355-5045 |
| Mailing Address |
Po Box 27842 New York NY 10087-7842 |
| Practice Telephone | 7186702900 |
| Practice Fax Number | 7186617827 |
| Mailing Telephone | 7186618711 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2010-12-22 |
| Authorized Official Name | MS. DORA HARTOFILIS (ACTING DIRECTOR OF BILLING) |
| Authorized Official Telephone | 7186618711 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01115737 | 05 |
| Street Address |
5645 MAIN ST |
| City | FLUSHING |
| State | NY |
| Zip Code | 11355-5045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821094400 | Maryanne Chin | Nurse Anesthetist, Certified Registered | 5645 Main St, Flushing, NY 11355-5045 | 2005-06-28 |
| 1093315160 | Ashlee Mishae Dillon | Registered Nurse | 5645 Main St, Flushing, NY 11355-5045 | 2020-10-28 |
| 1275131229 | Dakai Liu | Spec/Tech, Pathology | 5645 Main St, Flushing, NY 11355-5045 | 2020-10-13 |
| 1194322552 | Priyamvada Pillai | Student in an Organized Health Care Education/Training Program | 5645 Main St, Flushing, NY 11355-5045 | 2020-10-07 |
| 1831705078 | Justine Chirichella | Dietitian, Registered | 5645 Main St, Flushing, NY 11355-5045 | 2020-09-22 |
| 1063037422 | Chuhyun Jana Myong | Pharmacist | 5645 Main St, Flushing, NY 11355-5045 | 2020-06-11 |
| 1427673169 | Isabel Yuabov | Student in an Organized Health Care Education/Training Program | 5645 Main St, Flushing, NY 11355-5045 | 2020-06-09 |
| 1174147011 | Philemon Chu | Physician Assistant | 5645 Main St, Flushing, NY 11355-5045 | 2020-06-06 |
| 1710501044 | Lea Chernoff | Student in an Organized Health Care Education/Training Program | 5645 Main St, Flushing, NY 11355-5045 | 2020-06-02 |
| 1639793201 | Jiawen Huang | Physician Assistant | 5645 Main St, Flushing, NY 11355-5045 | 2020-05-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588281364 | Antoinette Sanon | Registered Nurse | 42-49 Alban St, Flushing, NY 11355 | 2020-06-29 |
| 1336765353 | Jayesh Nakum | Physical Therapist | 43-32 Kissena Blvd, Apt # 15d, New York, NY 11355 | 2020-06-25 |
| 1417582990 | Royal Class Home Health Care Agency, Inc | Home Health | 143-26 41st Avenue 2nd Floor, Flushing, NY 11355 | 2020-03-05 |
| 1356972673 | Christine Samuel | Nurse Practitioner | Nyp Queens, 56-45 Main Street, Flushing, NY 11355 | 2020-01-27 |
| 1740842590 | Ji Nu Lee | Acupuncturist | 138 49 Barclay Ave. 6a, Flushing, NY 11355 | 2019-07-02 |
| 1386203990 | Paula Scharffenberg | Registered Nurse | 140-50 Poelar Ave, Queens, NM 11355 | 2019-06-07 |
| 1821655101 | Erin Cisney | Student in an Organized Health Care Education/Training Program | 5654 Main St, Flushing, NY 11355 | 2019-05-22 |
| 1356810063 | Sanjay Lodha Physician PC | Internal Medicine | 45 72 Parsons Lewis Blvd, Flushing, NY 11355 | 2018-11-26 |
| 1740756576 | Allday Pharmacy Inc | Pharmacy | 4199 Main St, Suite 202a, Flushing, NY 11355 | 2018-10-19 |
| 1477035806 | Xiaona Mo | Acupuncturist | 42-67 Saull St #b, Flushing, NY 11355 | 2018-09-01 |
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| 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 |
|---|---|---|---|---|
| 1366596322 | Harrison Te Ming Mu | Neurological Surgery | 13620 38th Ave Ste 6a, Flushing, NY 11354-4263 | 2007-01-23 |
| 1417909169 | Jaime H Nieto | Neurological Surgery | 5620 Main St, Flushing, NY 11355-5046 | 2006-05-17 |
| 1700412897 | Ingrid Benites | Neurological Surgery | 5620 Main St, Flushing, NY 11355-5046 | 2020-03-20 |
| 1467616003 | Murisiku Raifu | Neurological Surgery | 5645 Main St, Rm-m204, Flushing, NY 11355-5045 | 2008-07-14 |
| 1629115308 | Peter Hollis | Neurological Surgery | 4500 Parsons Blvd, Flushing, NY 11355-2205 | 2007-01-31 |
| 1558454637 | John K Park | Neurological Surgery | 5645 Main St, Flushing, NY 11355-5045 | 2006-10-02 |
| 1336153097 | Nyhmcq-pediatrics Ambulatory Services | Neurological Surgery | 5645 Main St, Flushing, NY 11355-5045 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143933 | Antonio Bernardo | Neurological Surgery | 1330 1st Ave Apt 709, New York, NY 10021-4783 | 2020-10-31 |
| 1477177301 | Muhammad Waqas | Neurological Surgery | 100 High St Ste B4-27, Buffalo, NY 14203-1126 | 2020-06-06 |
| 1053949248 | All Island Medical Services. P.C. | Neurological Surgery | 1717 Veterans Memorial Highway, Suite 2, Islandia, NY 11749 | 2020-04-01 |
| 1083259675 | Kimon Bekelis Physician P C | Neurological Surgery | 60 George St, Babylon, NY 11702-2806 | 2019-11-07 |
| 1740844141 | Neurosurgery of Western Ny Pllc | Neurological Surgery | 1200 Jefferson Rd Ste 310, Rochester, NY 14623-3158 | 2019-05-01 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1902372980 | Jenkins Neurospine LLC | Neurological Surgery | 65 E 96th St Apt 1b, New York, NY 10128-0776 | 2018-10-17 |
| 1619454568 | Arthur Jenkins Md LLC | Neurological Surgery | 65 Eat 96th Street, Suite 1b, New York, NY 10128 | 2018-07-24 |
| 1710480496 | Level One Neurology, LLC | Neurological Surgery | 19 Baker Ave Ste 301, Poughkeepsie, NY 12601-1385 | 2018-03-09 |
| 1679091227 | J Pain & Spine Care | Neurological Surgery | 217 Old Ithaca Rd, Horseheads, NY 14845 | 2017-09-05 |
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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.