Provider Demographics
NPI:1568659456
Name:NEW ALBANY NEUROLOGY, PSC
Entity Type:Organization
Organization Name:NEW ALBANY NEUROLOGY, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKIF
Authorized Official - Middle Name:M
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-944-0367
Mailing Address - Street 1:1919 STATE ST STE 305
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-6806
Mailing Address - Country:US
Mailing Address - Phone:812-944-0367
Mailing Address - Fax:812-944-1279
Practice Address - Street 1:1919 STATE ST STE 305
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6806
Practice Address - Country:US
Practice Address - Phone:812-944-0367
Practice Address - Fax:812-944-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052746A2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000198233OtherANTHEM
IN184190Medicare PIN
G78593Medicare UPIN