Provider Demographics
NPI:1467607770
Name:AZ NEUROREADING, LLC
Entity Type:Organization
Organization Name:AZ NEUROREADING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHICHELLI
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:281-462-1285
Mailing Address - Street 1:PO BOX 1288
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-1288
Mailing Address - Country:US
Mailing Address - Phone:281-462-1285
Mailing Address - Fax:281-462-1554
Practice Address - Street 1:10105 E VIA LINDA
Practice Address - Street 2:STE 103-274
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5311
Practice Address - Country:US
Practice Address - Phone:281-462-1285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory