Provider Demographics
NPI:1598020497
Name:NORTH CAROLINA NEUROLOGY AND SLEEP PLLC
Entity Type:Organization
Organization Name:NORTH CAROLINA NEUROLOGY AND SLEEP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:PETERSON
Authorized Official - Middle Name:F
Authorized Official - Last Name:GIALLANZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-943-8296
Mailing Address - Street 1:403 GILEAD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6813
Mailing Address - Country:US
Mailing Address - Phone:704-464-1509
Mailing Address - Fax:704-464-1393
Practice Address - Street 1:403 GILEAD RD
Practice Address - Street 2:SUITE B
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6813
Practice Address - Country:US
Practice Address - Phone:704-464-1509
Practice Address - Fax:704-464-1393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-07
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-01902174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty