Provider Demographics
NPI:1578739942
Name:ST CECILIA NEUROLOGY SERVICES,LLC
Entity Type:Organization
Organization Name:ST CECILIA NEUROLOGY SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:
Authorized Official - First Name:M.CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINTO LORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-749-2350
Mailing Address - Street 1:750 CENTRAL AVE STE S
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3434
Mailing Address - Country:US
Mailing Address - Phone:603-749-2350
Mailing Address - Fax:603-743-4350
Practice Address - Street 1:750 CENTRAL AVE STE S
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3434
Practice Address - Country:US
Practice Address - Phone:603-749-2350
Practice Address - Fax:603-743-4350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH70982084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty