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General NPI Number Information
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NPI Number | 1477352698
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Entity Type | Organization
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Legal Business Name | NEURO DEVELOPMENTAL SLEEP PLLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 8601 W EMERALD ST STE 176
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City | BOISE
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State | ID
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Zip | 83704-8297
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Country | US
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Telephone | 208-793-7006
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Fax |
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Provider Business Mailing Address
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Address Line | 3327 N EAGLE RD STE 110-129
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City | MERIDIAN
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State | ID
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Zip | 83646-6141
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Country | US
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Telephone | 760-898-0430
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMALIA GELLER
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Credential | MD
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Telephone | 760-898-0430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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