Provider Demographics
NPI:1609980259
Name:SUMMIT NEUROLOGICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:SUMMIT NEUROLOGICAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-848-3415
Mailing Address - Street 1:169 5TH ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-9003
Mailing Address - Country:US
Mailing Address - Phone:330-848-3415
Mailing Address - Fax:330-848-2021
Practice Address - Street 1:400 WABASH AVE
Practice Address - Street 2:SUITE 260 POB
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2433
Practice Address - Country:US
Practice Address - Phone:330-344-1989
Practice Address - Fax:330-344-1596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350337712084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2365837Medicaid
OH2365819Medicaid
OH0969475Medicaid
OH0969475Medicaid
OH2365837Medicaid
OH2365819Medicaid