Provider Demographics
NPI:1205148590
Name:COMPREHENSIVE NEURODIAGNOSTIC SERVICES,P.A.
Entity type:Organization
Organization Name:COMPREHENSIVE NEURODIAGNOSTIC SERVICES,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DORO
Authorized Official - Last Name:SERANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-489-9200
Mailing Address - Street 1:1830 OWEN DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-1611
Mailing Address - Country:US
Mailing Address - Phone:910-223-5111
Mailing Address - Fax:910-229-2285
Practice Address - Street 1:1830 OWEN DR
Practice Address - Street 2:SUITE 104
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-1611
Practice Address - Country:US
Practice Address - Phone:910-223-5111
Practice Address - Fax:910-229-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-02
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty