Healthcare Provider Details

I. General information

NPI: 1619743895
Provider Name (Legal Business Name): NEURO INTEGRITY INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 WESTWOOD PLZ RM 1-194
LOS ANGELES CA
90095-8353
US

IV. Provider business mailing address

11049 MAGNOLIA BLVD APT 602
NORTH HOLLYWOOD CA
91601-5664
US

V. Phone/Fax

Practice location:
  • Phone: 310-206-3093
  • Fax:
Mailing address:
  • Phone: 818-207-0267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2472E0500X
TaxonomyEEG Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOE ROMER
Title or Position: PRESIDENT
Credential: CNIM, R.EP T.
Phone: 818-207-0267