Provider Demographics
NPI:1922231570
Name:NEUROLOGY HEALTHCARE LLC
Entity Type:Organization
Organization Name:NEUROLOGY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMER
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ABOUL-ELSAAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-299-1218
Mailing Address - Street 1:PO BOX 42185
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-0185
Mailing Address - Country:US
Mailing Address - Phone:513-299-1218
Mailing Address - Fax:
Practice Address - Street 1:3020 HOSPITAL DR
Practice Address - Street 2:SUITE 240
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-1962
Practice Address - Country:US
Practice Address - Phone:513-299-1218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2994998Medicaid
DP6903OtherMEDICARE RR
OH9384481Medicare PIN