Provider Demographics
NPI:1689792921
Name:NEUROPSYCHOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT -NEUROPSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHIULLI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-889-0426
Mailing Address - Street 1:2201 SAN PEDRO DR NE
Mailing Address - Street 2:BUILDING 1, SUITE 215
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4133
Mailing Address - Country:US
Mailing Address - Phone:505-889-0426
Mailing Address - Fax:505-883-7304
Practice Address - Street 1:2201 SAN PEDRO DR NE
Practice Address - Street 2:BUILDING 1, SUITE 215
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4133
Practice Address - Country:US
Practice Address - Phone:505-889-0426
Practice Address - Fax:505-883-7304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM201011047OtherPRESBYTERIAN HEALTH PLAN
NMNM00NB60OtherBLUE CROSS
NM7395OtherLOVELACE HEALTH PLAN
NM201001748OtherPRESBYTERIAN HEALTH PLAN
NM7395OtherCIGNA
NM201001748OtherPRESBYTERIAN HEALTH PLAN
NM=========OtherUNITED HEALTHCARE
NM7395OtherCIGNA