MEDICARE: NEUROLOGY AND NEUROSCIENCE ASSOCIATES, INC.

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	207RS0012X	Sleep Medicine (Internal Medicine) Physician
2	2084N0400X	Neurology 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	:	1720039670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGY AND NEUROSCIENCE ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 92168
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44191-2168
Country	:	US
Telephone Number	:	888-328-4472
Fax Number	:	330-493-7123

Provider Business Practice Location Address
First Line	:	4590 DRESSLER RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2546
Country	:	US
Telephone Number	:	888-719-9012
Fax Number	:	330-493-7123

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LAWRENCE M SALTIS
Credential	:	MD
Telephone Number	:	330-376-1902

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	05/07/2008

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