Provider Demographics
NPI:1073604286
Name:COASTAL NEUROLOGY SERVICES
Entity Type:Organization
Organization Name:COASTAL NEUROLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOSLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-749-0913
Mailing Address - Street 1:113 NEW ROCHESTER RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-8800
Mailing Address - Country:US
Mailing Address - Phone:603-749-0913
Mailing Address - Fax:603-750-4072
Practice Address - Street 1:113 NEW ROCHESTER RD
Practice Address - Street 2:SUITE 5
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-8800
Practice Address - Country:US
Practice Address - Phone:603-749-0913
Practice Address - Fax:603-750-4072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80001325Medicaid
NH80001325Medicaid