Provider Demographics
NPI:1033451075
Name:NEURODIAGNOSTICS GROUP, LLC
Entity Type:Organization
Organization Name:NEURODIAGNOSTICS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-715-9024
Mailing Address - Street 1:950 E HARVARD AVE
Mailing Address - Street 2:STE 570
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-7009
Mailing Address - Country:US
Mailing Address - Phone:303-715-9024
Mailing Address - Fax:303-715-7057
Practice Address - Street 1:950 E HARVARD AVE
Practice Address - Street 2:STE 570
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-7009
Practice Address - Country:US
Practice Address - Phone:303-715-9024
Practice Address - Fax:303-715-7057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-16
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty