1285651125 NPI number — NEUROLOGY CONSULTANTS CORP

Table of content: (NPI 1285651125)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285651125 NPI number — NEUROLOGY CONSULTANTS CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROLOGY CONSULTANTS CORP
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:
1285651125
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7534
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MC LEAN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22106-7534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-635-3275
Provider Business Mailing Address Fax Number:
703-286-5096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8303 ARLINGTON BLVD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22031-2903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-635-3275
Provider Business Practice Location Address Fax Number:
703-286-5096
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MANEM
Authorized Official First Name:
SUNEETHA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
703-635-3275

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  101235954 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 010259703 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com