Provider Demographics
NPI:1295209807
Name:NH NEUROFEEDBACK CENTER LLC
Entity Type:Organization
Organization Name:NH NEUROFEEDBACK CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMANTIDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-990-9951
Mailing Address - Street 1:26 E PEARL ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3459
Mailing Address - Country:US
Mailing Address - Phone:561-990-9951
Mailing Address - Fax:603-386-6404
Practice Address - Street 1:26 E PEARL ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3459
Practice Address - Country:US
Practice Address - Phone:603-780-4930
Practice Address - Fax:603-386-6404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty