Provider Demographics
NPI:1164994166
Name:ACCLAIM NEURODIAGNOSTICS GROUP
Entity Type:Organization
Organization Name:ACCLAIM NEURODIAGNOSTICS GROUP
Other - Org Name:ACCLAIM NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:RAMSES
Authorized Official - Last Name:YACOUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-996-9010
Mailing Address - Street 1:1423 CAPITOL TRL STE 1114
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5709
Mailing Address - Country:US
Mailing Address - Phone:302-932-9456
Mailing Address - Fax:302-996-9027
Practice Address - Street 1:1423 CAPITOL TRL STE 1114
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5709
Practice Address - Country:US
Practice Address - Phone:302-932-9456
Practice Address - Fax:302-996-9027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty