Provider Demographics
NPI:1689614406
Name:CENTER FOR NEUROLOGICAL TREATMENT & RESEARCH, PLLC
Entity Type:Organization
Organization Name:CENTER FOR NEUROLOGICAL TREATMENT & RESEARCH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBINOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-355-5510
Mailing Address - Street 1:301 QUECREEK CIR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6834
Mailing Address - Country:US
Mailing Address - Phone:615-355-5510
Mailing Address - Fax:615-355-8699
Practice Address - Street 1:301 QUECREEK CIR
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6834
Practice Address - Country:US
Practice Address - Phone:615-355-5510
Practice Address - Fax:615-355-8699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD194152084N0400X
TNDO11452084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10080086Medicaid
TN130020427OtherRAILROAD MEDICARE
TN2148317OtherCIGNA
TN2177476OtherCIGNA
TN3042647Medicaid
TN5430482OtherAETNA
TN3802609Medicaid
TNTN0101Medicaid
TN0094864OtherBLUECROSS BLUESHIELD
TN3042648Medicaid
TN01038929Medicaid
TN10080085Medicaid
TN6508106OtherCIGNA
TN130025292OtherRAILROAD MEDICARE
TN3039399OtherBLUE CROSS BLUESHIELD
TNGC4522OtherRAILROAD MEDICARE
TNTN0107Medicaid
TN5430482OtherAETNA
TNTN0107Medicaid
TNGC4522OtherRAILROAD MEDICARE
TNG34269Medicare UPIN
TN3802609Medicaid
TN3717552Medicare PIN