Provider Demographics
NPI:1992857817
Name:NEUROLOGY CONSULTANTS OF CAPE COD PC
Entity Type:Organization
Organization Name:NEUROLOGY CONSULTANTS OF CAPE COD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-622-3045
Mailing Address - Street 1:2 LYNXHOLM CT
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3019
Mailing Address - Country:US
Mailing Address - Phone:800-622-3045
Mailing Address - Fax:
Practice Address - Street 1:2 LYNXHOLM CT
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3019
Practice Address - Country:US
Practice Address - Phone:800-622-3045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80980174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18992OtherBLUE SHIELD
MAF33690Medicare UPIN
MAM21675Medicare ID - Type UnspecifiedMEDICARE