Provider Demographics
NPI:1437294691
Name:NEURO OPHTHALMIC SERVICES, P.C
Entity Type:Organization
Organization Name:NEURO OPHTHALMIC SERVICES, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,MBA,MPH
Authorized Official - Phone:248-551-8282
Mailing Address - Street 1:3535 W 13 MILE RD
Mailing Address - Street 2:SUITE 506
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6710
Mailing Address - Country:US
Mailing Address - Phone:248-551-8282
Mailing Address - Fax:248-551-9085
Practice Address - Street 1:3535 W 13 MILE RD
Practice Address - Street 2:SUITE 506
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-551-8282
Practice Address - Fax:248-551-9085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI336622207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty