Provider Demographics
NPI:1205293487
Name:NEUROPCO LLC
Entity type:Organization
Organization Name:NEUROPCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-363-4830
Mailing Address - Street 1:4578 N 1ST AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5747
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4061 E VIA DEL VIREO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-3311
Practice Address - Country:US
Practice Address - Phone:917-363-4830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health