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General NPI Number Information
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NPI Number | 1316940851
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Entity Type | Organization
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Legal Business Name | NEUROPSYCHIATRIC ASSOCIATES, PC
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Dates
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Enumeration Date | 05/28/2005
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Last Update Date | 02/15/2011
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Provider Practice Location Address
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Address Line | 2410 N GLENDALE DR STE A
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City | FORT WAYNE
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State | IN
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Zip | 46804-8909
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Country | US
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Telephone | 260-432-5181
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Fax | 260-432-5692
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Provider Business Mailing Address
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Address Line | 2410 N GLENDALE DR STE A
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City | FORT WAYNE
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State | IN
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Zip | 46804-8909
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Country | US
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Telephone | 260-432-5181
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Fax | 260-432-5692
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Authorized Official
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Title or Position | CAO
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Name | MR. NEAL K BISHT
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Credential | MBA
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Telephone | 260-432-5181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 50003238A
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License Number State | IN
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