Provider Demographics
NPI:1033284005
Name:RIVER CITIES NEUROLOGY, P.S.C
Entity Type:Organization
Organization Name:RIVER CITIES NEUROLOGY, P.S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PRAMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:BHASIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-833-0876
Mailing Address - Street 1:378 DIEDERICH BLVD
Mailing Address - Street 2:PMB #270
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101
Mailing Address - Country:US
Mailing Address - Phone:606-833-0876
Mailing Address - Fax:606-833-0916
Practice Address - Street 1:700 ST CHRISTOPHER DR
Practice Address - Street 2:MED BLDG 3 STE 102
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101
Practice Address - Country:US
Practice Address - Phone:606-833-0876
Practice Address - Fax:606-833-0916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY376442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2867894Medicaid
000000247596OtherBCBS
KY7100062990Medicaid
KY6145650001Medicare NSC
KY7100062990Medicaid
000000247596OtherBCBS
KY7576Medicare PIN