Provider Demographics
NPI:1124011440
Name:NEUROCARE, INC.
Entity Type:Organization
Organization Name:NEUROCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-796-7766
Mailing Address - Street 1:70 WELLS AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3210
Mailing Address - Country:US
Mailing Address - Phone:617-796-7766
Mailing Address - Fax:617-796-9099
Practice Address - Street 1:70 WELLS AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-3210
Practice Address - Country:US
Practice Address - Phone:617-796-7766
Practice Address - Fax:617-796-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA603116OtherHARVARDPILGRIMHEALTHCARE
MA0577845OtherAETNA US HEALTHCARE
MASF038269OtherBCBS OF MA
MA713709OtherTUFTS
MA=========OtherUNITED HEALTH CARE
MA=========OtherUNICARE
MA=========OtherTRICARE
MASF038269OtherBCBS OF MA
MA=========OtherCIGNA