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General NPI Number Information
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NPI Number | 1245518844
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Entity Type | Organization
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Legal Business Name | NERVELINK NEUROMONITORING, LLC
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Dates
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Enumeration Date | 07/30/2011
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | 2318 MAIN ST STE 2
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City | STRATFORD
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State | CT
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Zip | 06615-5966
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Country | US
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Telephone | 203-923-8540
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Fax | 203-549-0755
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Provider Business Mailing Address
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Address Line | 2318 MAIN ST STE 2
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City | STRATFORD
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State | CT
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Zip | 06615-5966
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Country | US
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Telephone | 203-923-8540
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Fax | 203-549-0755
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Authorized Official
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Title or Position | OWNER
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Name | MR. YVETTE MAURICE
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Credential | R.EP T, CNIM
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Telephone | 203-923-8540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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