Provider Demographics
NPI:1508161316
Name:NEUROLOGY ASSOCIATES OF ALBANY PC
Entity Type:Organization
Organization Name:NEUROLOGY ASSOCIATES OF ALBANY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ASTWANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-446-9477
Mailing Address - Street 1:PO BOX 6163
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31706-6163
Mailing Address - Country:US
Mailing Address - Phone:229-446-9477
Mailing Address - Fax:
Practice Address - Street 1:701 14TH AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1301
Practice Address - Country:US
Practice Address - Phone:229-446-9477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0369172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty