Provider Demographics
NPI:1114792611
Name:NEURO WATCH LLC
Entity Type:Organization
Organization Name:NEURO WATCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBION
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-206-6844
Mailing Address - Street 1:5540 CENTERVIEW DR STE 204
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-8012
Mailing Address - Country:US
Mailing Address - Phone:714-206-6844
Mailing Address - Fax:
Practice Address - Street 1:5540 CENTERVIEW DR STE 204
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-8012
Practice Address - Country:US
Practice Address - Phone:714-206-6844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty