Provider Demographics
NPI:1972838498
Name:NEUROLOGY ASSOCIATES OF SUFFOLK, PLLC
Entity Type:Organization
Organization Name:NEUROLOGY ASSOCIATES OF SUFFOLK, PLLC
Other - Org Name:NEUROLOGY AND SLEEP ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:HOLLAND
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-967-0406
Mailing Address - Street 1:150 BURNETTS WAY
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8168
Mailing Address - Country:US
Mailing Address - Phone:757-934-1900
Mailing Address - Fax:757-925-6719
Practice Address - Street 1:5839 HARBOUR VIEW BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3797
Practice Address - Country:US
Practice Address - Phone:757-967-0406
Practice Address - Fax:757-967-0675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty