Provider Demographics
NPI:1508891581
Name:CENTER FOR NEUROLOGY AND STROKE PLC
Entity Type:Organization
Organization Name:CENTER FOR NEUROLOGY AND STROKE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:AVINASH
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHATTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-335-0300
Mailing Address - Street 1:333 W THOMAS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4417
Mailing Address - Country:US
Mailing Address - Phone:602-335-0300
Mailing Address - Fax:602-249-3311
Practice Address - Street 1:333 W THOMAS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4417
Practice Address - Country:US
Practice Address - Phone:602-335-0300
Practice Address - Fax:602-249-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ380092084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ65149Medicare ID - Type UnspecifiedCOMPANY MEDICARE #