Healthcare Provider Details

I. General information

NPI: 1881365575
Provider Name (Legal Business Name): NEEMAI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 42ND ST N
CEDAR RAPIDS IA
52402
US

IV. Provider business mailing address

650 KINGFISHER LN UNIT E
WOODBURY MN
55125
US

V. Phone/Fax

Practice location:
  • Phone: 651-424-9993
  • Fax:
Mailing address:
  • Phone: 651-424-9993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. NGULWE K. ALFANI
Title or Position: PROJECT MANAGER
Credential:
Phone: 651-424-9993