Provider Demographics
NPI:1528229580
Name:NEUROEDUCATION
Entity Type:Organization
Organization Name:NEUROEDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCORMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-382-5400
Mailing Address - Street 1:PO BOX 882
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-0882
Mailing Address - Country:US
Mailing Address - Phone:603-382-5400
Mailing Address - Fax:603-382-4283
Practice Address - Street 1:145 WARD HILL AVE
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:MA
Practice Address - Zip Code:01835-6928
Practice Address - Country:US
Practice Address - Phone:603-382-5400
Practice Address - Fax:603-382-4283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6540173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty