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General NPI Number Information
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NPI Number | 1285651125
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Entity Type | Organization
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Legal Business Name | NEUROLOGY CONSULTANTS CORP
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 8303 ARLINGTON BLVD SUITE 202
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City | FAIRFAX
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State | VA
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Zip | 22031-2903
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Country | US
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Telephone | 703-635-3275
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Fax | 703-286-5096
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Provider Business Mailing Address
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Address Line | PO BOX 7534
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City | MC LEAN
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State | VA
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Zip | 22106-7534
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Country | US
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Telephone | 703-635-3275
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Fax | 703-286-5096
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SUNEETHA MANEM
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Credential | M.D.
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Telephone | 703-635-3275
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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 | 101235954
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License Number State | VA
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