Healthcare Provider Details

I. General information

NPI: 1154509941
Provider Name (Legal Business Name): CENTER NEUROLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6285 GARDEN WALK BLVD SUITE C
RIVERDALE GA
30274-2612
US

IV. Provider business mailing address

6285 GARDEN WALK BLVD SUITE C
RIVERDALE GA
30274-2612
US

V. Phone/Fax

Practice location:
  • Phone: 770-996-1352
  • Fax: 770-991-0850
Mailing address:
  • Phone: 770-996-1352
  • Fax: 770-991-0850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number022177
License Number StateGA

VIII. Authorized Official

Name: DR. JOSEPH N. SABA
Title or Position: OWNER
Credential: M.D.
Phone: 770-996-1352