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General NPI Number Information
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NPI Number | 1659511780
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Entity Type | Organization
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Legal Business Name | CENTER FOR NEUROLOGY & SLEEP DISORDERS, SC
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 240 REGENCY CT SUITE 201
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City | BROOKFIELD
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State | WI
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Zip | 53045-6162
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Country | US
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Telephone | 262-787-5400
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Fax | 262-787-5400
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Provider Business Mailing Address
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Address Line | 240 REGENCY CT SUITE 201
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City | BROOKFIELD
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State | WI
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Zip | 53045-6162
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Country | US
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Telephone | 262-787-5400
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Fax | 262-787-5400
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Authorized Official
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Title or Position | OWNER
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Name | DR. NIHAL HERATH
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Credential | F.A.A.S.M.
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Telephone | 262-787-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 40848-020
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License Number State | WI
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