Healthcare Provider Details

I. General information

NPI: 1699553149
Provider Name (Legal Business Name): NEUROVISIONARY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 09/18/2023
Certification Date: 09/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CRAYTON OAK DR
CARY NC
27519-3600
US

IV. Provider business mailing address

451 CRAYTON OAK DR
CARY NC
27519-3600
US

V. Phone/Fax

Practice location:
  • Phone: 601-620-7366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: GABRIELLA SZATMARY
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD, PHD
Phone: 601-620-7366