NPI Code Detail JSON Logo

1053101238 NPI number — PRECISION NEUROLOGY ASSOCIATES PLLC

NPI Number: 1053101238
Health Care Provider/Practitioner: PRECISION NEUROLOGY ASSOCIATES PLLC

Information about “1053101238” NPI (PRECISION NEUROLOGY ASSOCIATES PLLC) exists in 1053101238 in HTML format HTML  |  1053101238 in plain Text format TXT  |  1053101238 in PDF (Portable Document Format) PDF  |  1053101238 in an XML format XML  formats.

NPI Number : 1053101238 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053101238",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PRECISION NEUROLOGY ASSOCIATES PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "115 NORWOOD PARK S STE 106",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORWOOD",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02062-4633",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "781-352-4777",
    "MailingAddressFaxNumber": "781-352-4778",
    "FirstLinePracticeLocationAddress": "2 DUDLEY ST STE 2",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PROVIDENCE",
    "PracticeLocationAddressStateName": "RI",
    "PracticeLocationAddressPostalCode": "02905-3236",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "781-352-4777",
    "PracticeLocationAddressFaxNumber": "781-352-4778",
    "EnumerationDate": "05/09/2025",
    "LastUpdateDate": "12/16/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "RODRIGUES",
    "AuthorizedOfficialFirstName": "ANTHONY",
    "AuthorizedOfficialMiddleName": "CARL",
    "AuthorizedOfficialTitle": "AUTHORIZED OFFICIAL",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "781-352-4777",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2084N0402X",
          "TaxonomyName": "Neurology with Special Qualifications in Child Neurology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084E0001X",
          "TaxonomyName": "Epilepsy Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2080P0008X",
          "TaxonomyName": "Pediatric Neurodevelopmental Disabilities Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084N0400X",
          "TaxonomyName": "Neurology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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