Provider Demographics
NPI:1750486775
Name:OHIO NEUROLOGY AND HEADACHE CENTER OF EXCELLANCE, INC
Entity Type:Organization
Organization Name:OHIO NEUROLOGY AND HEADACHE CENTER OF EXCELLANCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDELHAKIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-760-0666
Mailing Address - Street 1:6805 AVERY MUIRFIELD RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-7180
Mailing Address - Country:US
Mailing Address - Phone:614-760-0666
Mailing Address - Fax:614-760-0667
Practice Address - Street 1:6805 AVERY MUIRFIELD RD
Practice Address - Street 2:SUITE 202
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-7180
Practice Address - Country:US
Practice Address - Phone:614-760-0666
Practice Address - Fax:614-760-0667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2009454Medicaid
OHDA7229OtherRAILROAD MEDICARE
OH9337381Medicare PIN