Provider Demographics
NPI:1467755066
Name:INNOVATIVE NEUROPHYSIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:INNOVATIVE NEUROPHYSIOLOGY ASSOCIATES
Other - Org Name:SOMA SOLUTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-099-6776
Mailing Address - Street 1:1716 NEW HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2311
Mailing Address - Country:US
Mailing Address - Phone:502-999-6776
Mailing Address - Fax:
Practice Address - Street 1:1716 NEW HAVEN ROAD
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004
Practice Address - Country:US
Practice Address - Phone:502-996-1578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty