Provider Demographics
NPI:1255635884
Name:NW VALLEY NEUROLOGY & PARKINSON'S CARE SPECIALISTS PLLC
Entity type:Organization
Organization Name:NW VALLEY NEUROLOGY & PARKINSON'S CARE SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-246-3300
Mailing Address - Street 1:1840 W MARYLAND AVE
Mailing Address - Street 2:STE B
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1705
Mailing Address - Country:US
Mailing Address - Phone:602-246-3300
Mailing Address - Fax:602-246-3303
Practice Address - Street 1:1840 W MARYLAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1705
Practice Address - Country:US
Practice Address - Phone:602-246-3300
Practice Address - Fax:602-246-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ343612084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ593254Medicaid
AZZ143136Medicare PIN