1518384700 NPI number — COMPREHENSIVE NEURO MONITORING, LLC

Table of content: DR. RICHARD TAYLOR ROBINSON MD (NPI 1720128150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518384700 NPI number — COMPREHENSIVE NEURO MONITORING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPREHENSIVE NEURO MONITORING, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518384700
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4570 AVERY LN SE STE C-10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LACEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98503-5608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-755-1921
Provider Business Mailing Address Fax Number:
360-925-3470

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45211 HELM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48170-6023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-525-9712
Provider Business Practice Location Address Fax Number:
734-245-4092
Provider Enumeration Date:
03/25/2014

Additional Information

Authorized Official

Authorized Official Last Name:
FANELLI
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF CLINICAL OFFICER
Authorized Official Telephone Number:
480-755-1921

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com