Provider Demographics
NPI:1083722482
Name:NEUROLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:NEUROLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-485-2510
Mailing Address - Street 1:1985 TATE BLVD SE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1433
Mailing Address - Country:US
Mailing Address - Phone:828-328-5500
Mailing Address - Fax:828-485-2517
Practice Address - Street 1:1985 TATE BLVD SE
Practice Address - Street 2:SUITE 600
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1433
Practice Address - Country:US
Practice Address - Phone:828-328-5500
Practice Address - Fax:828-485-2517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29620174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8988268Medicaid
NC5901715Medicaid
NC8953912Medicaid
NC2042031Medicare ID - Type UnspecifiedMEDICARE #
NC8953912Medicaid
NCG23327Medicare UPIN
NCQ36139Medicare UPIN
NC5901715Medicaid
NC2764337Medicare ID - Type UnspecifiedMEDICARE #
NCC82030Medicare UPIN
NC2220938AMedicare ID - Type UnspecifiedMEDICARE #
NC203714CMedicare ID - Type UnspecifiedMEDICARE #
NCH81252Medicare UPIN
NC8988268Medicaid
NCQ53453Medicare UPIN