Provider Demographics
NPI:1023613726
Name:MERRIMACK VALLEY NEUROLOGY LLC
Entity type:Organization
Organization Name:MERRIMACK VALLEY NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CREDENTIALING
Authorized Official - Phone:502-244-9859
Mailing Address - Street 1:200 SUTTON ST STE 140
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1651
Mailing Address - Country:US
Mailing Address - Phone:978-620-8444
Mailing Address - Fax:
Practice Address - Street 1:200 SUTTON ST STE 140
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1651
Practice Address - Country:US
Practice Address - Phone:978-620-8444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty