Provider Demographics
NPI:1245553577
Name:ALLIED NEURODIAGNOSTICS, LLC
Entity type:Organization
Organization Name:ALLIED NEURODIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:NIZNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-295-0052
Mailing Address - Street 1:3691 KENNESAW S INDUSTRIAL DR NW
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-6513
Mailing Address - Country:US
Mailing Address - Phone:770-792-9146
Mailing Address - Fax:770-792-9866
Practice Address - Street 1:3691 KENNESAW S INDUSTRIAL DR NW
Practice Address - Street 2:SUITE 103
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6513
Practice Address - Country:US
Practice Address - Phone:770-792-9146
Practice Address - Fax:770-792-9866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty