Provider Demographics
NPI:1366856239
Name:GREATER MILFORD NEUROLOGY, LLC
Entity Type:Organization
Organization Name:GREATER MILFORD NEUROLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-473-4439
Mailing Address - Street 1:54 HOPEDALE ST
Mailing Address - Street 2:
Mailing Address - City:HOPEDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01747-1700
Mailing Address - Country:US
Mailing Address - Phone:508-473-4323
Mailing Address - Fax:508-473-1695
Practice Address - Street 1:54 HOPEDALE ST
Practice Address - Street 2:
Practice Address - City:HOPEDALE
Practice Address - State:MA
Practice Address - Zip Code:01747-1700
Practice Address - Country:US
Practice Address - Phone:508-473-4323
Practice Address - Fax:508-473-1695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty