=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295645968
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALIA PEDIATRIC NEUROLOGY & EPILEPSY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2026
-----------------------------------------------------
Last Update Date | 09/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2770 WILDBERRY DR
-----------------------------------------------------
City | LOWELL
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49331-8972
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-463-8761
-----------------------------------------------------
Fax | 616-226-4837
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2770 WILDBERRY DR
-----------------------------------------------------
City | LOWELL
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49331-8972
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-463-8761
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ANASTASIA LUNIOVA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 718-915-3788
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084E0001X
-----------------------------------------------------
Taxonomy Name | Epilepsy Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084N0402X
-----------------------------------------------------
Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------