Provider Demographics
NPI:1407095227
Name:NEURODIAGNOSTICS CENETERS, LLC
Entity Type:Organization
Organization Name:NEURODIAGNOSTICS CENETERS, LLC
Other - Org Name:NEURONOST, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JUMOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINNAGBE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:410-897-8445
Mailing Address - Street 1:PO BOX 7225
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20792-7225
Mailing Address - Country:US
Mailing Address - Phone:301-651-7448
Mailing Address - Fax:888-595-9995
Practice Address - Street 1:7226 CORPORATE CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-8386
Practice Address - Country:US
Practice Address - Phone:301-651-7448
Practice Address - Fax:888-595-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0068367174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty