Provider Demographics
NPI:1952592610
Name:ASSOCIATES IN NEUROLOGY & EMG PC
Entity Type:Organization
Organization Name:ASSOCIATES IN NEUROLOGY & EMG PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KOLB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-921-1900
Mailing Address - Street 1:83 HERRICK ST
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2753
Mailing Address - Country:US
Mailing Address - Phone:978-921-1900
Mailing Address - Fax:978-921-6694
Practice Address - Street 1:83 HERRICK ST
Practice Address - Street 2:SUITE 1001
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2153
Practice Address - Country:US
Practice Address - Phone:978-921-1900
Practice Address - Fax:978-921-6694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0541792084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM15209OtherBCBS
MA9763279Medicaid
MA9763279Medicaid