Provider Demographics
NPI:1093956591
Name:NEUROLOGY ASSOCIATES OF LIMA
Entity Type:Organization
Organization Name:NEUROLOGY ASSOCIATES OF LIMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMUDALLAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-225-9210
Mailing Address - Street 1:770 W HIGH ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3990
Mailing Address - Country:US
Mailing Address - Phone:419-225-9210
Mailing Address - Fax:419-225-7472
Practice Address - Street 1:770 W HIGH ST
Practice Address - Street 2:SUITE 360
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3990
Practice Address - Country:US
Practice Address - Phone:419-225-9210
Practice Address - Fax:419-225-7472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076642A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2249696Medicaid
OH4047331Medicare PIN
OHH35076Medicare UPIN