Provider Demographics
NPI:1619911443
Name:THE NEUROLOGICAL INSTITUTE AND SPECIALTY CENTERS PC
Entity Type:Organization
Organization Name:THE NEUROLOGICAL INSTITUTE AND SPECIALTY CENTERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SALBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-769-0777
Mailing Address - Street 1:521 E 86TH AVE
Mailing Address - Street 2:SUITE Z
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6173
Mailing Address - Country:US
Mailing Address - Phone:219-769-0777
Mailing Address - Fax:219-755-0608
Practice Address - Street 1:521 E 86TH AVE
Practice Address - Street 2:SUITE Z
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6173
Practice Address - Country:US
Practice Address - Phone:219-769-0777
Practice Address - Fax:219-755-0608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50002000A207R00000X, 208100000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN497970Medicare PIN