1689626814 NPI number — NEUROLOGY AND NEUROSCIENCE ASSOCIATES, INC.

Table of content: (NPI 1689626814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689626814 NPI number — NEUROLOGY AND NEUROSCIENCE ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROLOGY AND NEUROSCIENCE ASSOCIATES, INC.
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:
1689626814
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 92168
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44191-2168
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-328-4472
Provider Business Mailing Address Fax Number:
330-493-7123

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
323 MARION AVE NW
Provider Second Line Business Practice Location Address:
SUITE B100
Provider Business Practice Location Address City Name:
MASSILLON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44646-3639
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-719-9012
Provider Business Practice Location Address Fax Number:
330-493-7123
Provider Enumeration Date:
05/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SALTIS
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
330-376-1902

Provider Taxonomy Codes

  • Taxonomy code: 207RS0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0480073 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: CF1561 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com