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General NPI Number Information
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NPI Number | 1689792921
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Entity Type | Organization
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Legal Business Name | NEUROPSYCHOLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 2201 SAN PEDRO DR NE BUILDING 1, SUITE 215
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4133
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Country | US
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Telephone | 505-889-0426
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Fax | 505-883-7304
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Provider Business Mailing Address
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Address Line | 2201 SAN PEDRO DR NE BUILDING 1, SUITE 215
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4133
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Country | US
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Telephone | 505-889-0426
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Fax | 505-883-7304
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Authorized Official
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Title or Position | PRESIDENT -NEUROPSYCHOLOGIST
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Name | STEPHEN J CHIULLI
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Credential | PH.D.
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Telephone | 505-889-0426
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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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