Provider Demographics
NPI:1780057984
Name:NEURALOGIX MANAGEMENT, LLC
Entity type:Organization
Organization Name:NEURALOGIX MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:G
Authorized Official - Last Name:ECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-539-3378
Mailing Address - Street 1:2612 SEVERN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5935
Mailing Address - Country:US
Mailing Address - Phone:833-274-6988
Mailing Address - Fax:
Practice Address - Street 1:2612 SEVERN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5935
Practice Address - Country:US
Practice Address - Phone:833-274-6988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
No293D00000XLaboratoriesPhysiological LaboratoryGroup - Single Specialty