Provider Demographics
NPI:1235291097
Name:THE NEUROSCIENCE TEAM INC.
Entity Type:Organization
Organization Name:THE NEUROSCIENCE TEAM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-828-7792
Mailing Address - Street 1:2328 W JOPPA RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4612
Mailing Address - Country:US
Mailing Address - Phone:410-828-7792
Mailing Address - Fax:
Practice Address - Street 1:2328 W JOPPA RD
Practice Address - Street 2:SUITE 10
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4612
Practice Address - Country:US
Practice Address - Phone:410-828-7792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02138103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH181NEMedicare ID - Type Unspecified