Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 233627 | NY |
N | 204C00000X | Sports Medicine Doctor | A100309 | CA |
NPI | 1780881581 |
---|---|
Provider Name | Brian Russell Neri |
First Address | New Hyde Park, NY 11042-1008 |
Second Address | East Meadow, NY 11554-2265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 12/11/2021 |