Provider Demographics
NPI:1760656946
Name:NEUROLOGICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:NEUROLOGICAL SERVICES, P.C.
Other - Org Name:NEUROLOGY TESTING SERVICE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-620-2800
Mailing Address - Street 1:PO BOX 2645
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01703-2645
Mailing Address - Country:US
Mailing Address - Phone:508-620-2804
Mailing Address - Fax:508-620-2808
Practice Address - Street 1:463 WORCESTER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5356
Practice Address - Country:US
Practice Address - Phone:508-820-0469
Practice Address - Fax:508-626-1985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
600134OtherTUFTS NUMBER
MAM15243OtherMEDICARE PROVIDER NUMBER
MA9768475Medicaid
600134OtherTUFTS NUMBER