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General NPI Number Information
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NPI Number | 1114025152
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Entity Type | Organization
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Legal Business Name | NEUROLOGIC ASSOCIATES, P.C.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 35 PEARL ST SUITE 201
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City | NEW BRITAIN
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State | CT
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Zip | 06051-2644
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Country | US
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Telephone | 860-223-3810
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Fax | 860-229-2621
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Provider Business Mailing Address
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Address Line | 35 PEARL ST SUITE 201
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City | NEW BRITAIN
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State | CT
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Zip | 06051-2644
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Country | US
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Telephone | 860-223-3810
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Fax | 860-229-2621
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDRE LERER
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Credential | M.D.
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Telephone | 860-223-3810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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