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General NPI Number Information
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NPI Number | 1326682899
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Entity Type | Organization
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Legal Business Name | NP NEUROPSYCHOLOGY, LLC
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Dates
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Enumeration Date | 10/29/2019
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 5775 PEACHTREE DUNWOODY RD C-200
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 404-398-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 4514 CHAMBLEE DUNWOODY RD #127
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City | ATLANTA
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State | GA
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Zip | 30338-6272
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Country | US
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Telephone | 404-398-1081
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Fax |
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Authorized Official
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Title or Position | NEUROPSYCHOLOGIST/OWNER
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Name | ERNEST FUNG
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Credential | PSYD
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Telephone | 404-398-1081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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