Provider Demographics
NPI:1659511780
Name:CENTER FOR NEUROLOGY & SLEEP DISORDERS, SC
Entity Type:Organization
Organization Name:CENTER FOR NEUROLOGY & SLEEP DISORDERS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERATH
Authorized Official - Suffix:
Authorized Official - Credentials:FAASM
Authorized Official - Phone:262-787-5400
Mailing Address - Street 1:240 REGENCY CT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-6162
Mailing Address - Country:US
Mailing Address - Phone:262-787-5400
Mailing Address - Fax:262-787-5400
Practice Address - Street 1:240 REGENCY CT
Practice Address - Street 2:SUITE 201
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-6162
Practice Address - Country:US
Practice Address - Phone:262-787-5400
Practice Address - Fax:262-787-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI40848-0202084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty