Provider Demographics
NPI:1285005116
Name:HEALTHY BRAIN NEUROLOGY CORP
Entity Type:Organization
Organization Name:HEALTHY BRAIN NEUROLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SVETIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-310-1308
Mailing Address - Street 1:3572 DAYTON XENIA RD STE 217
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45432-2838
Mailing Address - Country:US
Mailing Address - Phone:937-433-0085
Mailing Address - Fax:937-433-0084
Practice Address - Street 1:3572 DAYTON XENIA RD STE 217
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-2838
Practice Address - Country:US
Practice Address - Phone:937-433-0085
Practice Address - Fax:937-433-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0740142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty