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General NPI Number Information
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NPI Number | 1124011440
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Entity Type | Organization
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Legal Business Name | NEUROCARE, INC.
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 70 WELLS AVE SUITE 201
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City | NEWTON
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State | MA
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Zip | 02459-3210
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Country | US
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Telephone | 617-796-7766
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Fax | 617-796-9099
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Provider Business Mailing Address
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Address Line | 70 WELLS AVE SUITE 201
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City | NEWTON
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State | MA
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Zip | 02459-3210
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Country | US
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Telephone | 617-796-7766
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Fax | 617-796-9099
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. WILLIAM ROBERT MAYER
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Credential |
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Telephone | 617-796-7766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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