MEDICARE: NEONATOLOGY ASSOCIATES OF ATLANTA, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0203X	Pediatric Critical Care Medicine Physician
2	2080N0001X	Neonatal-Perinatal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194822809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEONATOLOGY ASSOCIATES OF ATLANTA, P.C.

Provider Business Mailing Address
First Line	:	1301 CONCORD TER
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-2843
Country	:	US
Telephone Number	:	800-243-3839
Fax Number	:	844-686-2961

Provider Business Practice Location Address
First Line	:	1001 JOHNSON FERRY RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-1605
Country	:	US
Telephone Number	:	404-785-5437
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	NICHOLAS E GLASER
Credential	:
Telephone Number	:	954-384-0175

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	12/10/2025

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