Provider Demographics
NPI:1558551069
Name:NEUROLOGY PARTNERS PC
Entity Type:Organization
Organization Name:NEUROLOGY PARTNERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TETREAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-742-5965
Mailing Address - Street 1:76 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2335
Mailing Address - Country:US
Mailing Address - Phone:508-431-2026
Mailing Address - Fax:508-431-2296
Practice Address - Street 1:76 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2335
Practice Address - Country:US
Practice Address - Phone:508-431-2026
Practice Address - Fax:508-431-2296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1500142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1780642611Medicaid
RI1780642611Medicaid
MA3187837Medicaid
MA1649703547Medicaid
RI1649703547Medicaid
RI1568975969Medicaid
MA1568975969Medicaid
RI1124090691Medicaid
MA1124090691Medicaid