Provider Demographics
NPI:1801195078
Name:THE NEUROSCIENCE TEAM LLC
Entity Type:Organization
Organization Name:THE NEUROSCIENCE TEAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMAR
Authorized Official - Middle Name:B
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:410-828-7792
Mailing Address - Street 1:22 WEST RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2326
Mailing Address - Country:US
Mailing Address - Phone:410-828-7792
Mailing Address - Fax:
Practice Address - Street 1:22 WEST RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2326
Practice Address - Country:US
Practice Address - Phone:410-828-7792
Practice Address - Fax:410-828-5620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-27
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04445103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty