Provider Demographics
NPI:1376568287
Name:ONTARIO NEUROLOGY ASSOCIATES
Entity Type:Organization
Organization Name:ONTARIO NEUROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-394-6811
Mailing Address - Street 1:195 PARRISH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1693
Mailing Address - Country:US
Mailing Address - Phone:585-394-6811
Mailing Address - Fax:585-394-7497
Practice Address - Street 1:195 PARRISH ST STE 220
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1693
Practice Address - Country:US
Practice Address - Phone:585-394-6811
Practice Address - Fax:585-394-7497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02685376Medicaid
NY02685376Medicaid