Provider Demographics
NPI:1295030187
Name:NORTHWEST INDIANA NEUROLOGICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:NORTHWEST INDIANA NEUROLOGICAL ASSOCIATES, PC
Other - Org Name:CENTER FOR DIZZINESS, BALANCE AND NEURO-REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ROZENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-836-2995
Mailing Address - Street 1:9200 CALUMET AVE
Mailing Address - Street 2:SUITE N100
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2885
Mailing Address - Country:US
Mailing Address - Phone:219-836-9100
Mailing Address - Fax:219-836-2361
Practice Address - Street 1:801 MACARTHUR BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2915
Practice Address - Country:US
Practice Address - Phone:219-836-2995
Practice Address - Fax:219-836-4075
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST INDIANA NEUROLOGICAL ASSOCIATES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-24
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
498700Medicare PIN