Provider Demographics
NPI:1922251032
Name:NEURODIAGNOSTIC CENTERS, LLC
Entity Type:Organization
Organization Name:NEURODIAGNOSTIC CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:JUMOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINNAGBE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:301-651-7448
Mailing Address - Street 1:PO BOX 7552
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20792-7552
Mailing Address - Country:US
Mailing Address - Phone:301-651-7448
Mailing Address - Fax:877-380-3437
Practice Address - Street 1:2629 RIVA RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7428
Practice Address - Country:US
Practice Address - Phone:301-651-7448
Practice Address - Fax:877-380-3437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty