Provider Demographics
NPI:1922245935
Name:SAFE PASSAGE NEUROMONITORING, LLC
Entity Type:Organization
Organization Name:SAFE PASSAGE NEUROMONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-571-7303
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14851-0515
Mailing Address - Country:US
Mailing Address - Phone:617-571-7303
Mailing Address - Fax:
Practice Address - Street 1:915 BROADWAY
Practice Address - Street 2:SUITE 1200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7108
Practice Address - Country:US
Practice Address - Phone:617-571-7303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty