1396778072 NPI number — NEURODIAGNOSTIC ASSOCIATES PC

Table of content: (NPI 1396778072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396778072 NPI number — NEURODIAGNOSTIC ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEURODIAGNOSTIC ASSOCIATES PC
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:
1396778072
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 IRVING STREET NW
Provider Second Line Business Mailing Address:
SUITE 2600
Provider Business Mailing Address City Name:
WASH
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20010-2997
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-829-3726
Provider Business Mailing Address Fax Number:
202-882-1468

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 IRVING STREET NW
Provider Second Line Business Practice Location Address:
SUITE 2600
Provider Business Practice Location Address City Name:
WASH
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20010-2997
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-829-3726
Provider Business Practice Location Address Fax Number:
202-882-1468
Provider Enumeration Date:
07/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BATIPPS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
202-829-3726

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9321 . This is a "CARE FIRST" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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