Provider Demographics
NPI:1790496156
Name:NS NEUROLOGY AND EMG
Entity Type:Organization
Organization Name:NS NEUROLOGY AND EMG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-922-2226
Mailing Address - Street 1:83 HERRICK ST STE 1001
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2753
Mailing Address - Country:US
Mailing Address - Phone:978-922-2226
Mailing Address - Fax:
Practice Address - Street 1:83 HERRICK ST STE 1001
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2753
Practice Address - Country:US
Practice Address - Phone:978-922-2226
Practice Address - Fax:978-922-2269
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH SHORE NEUROLOGY AND EMG LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty