Provider Demographics
NPI:1598901399
Name:CENTER FOR NEURODIAGNOSTICS
Entity Type:Organization
Organization Name:CENTER FOR NEURODIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BORROMEO
Authorized Official - Suffix:V
Authorized Official - Credentials:DC
Authorized Official - Phone:540-550-3907
Mailing Address - Street 1:125 PROSPERITY DR STE 600
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-5387
Mailing Address - Country:US
Mailing Address - Phone:540-550-3907
Mailing Address - Fax:
Practice Address - Street 1:125 PROSPERITY DR STE 600
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-5387
Practice Address - Country:US
Practice Address - Phone:540-550-3907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center