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General NPI Number Information
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NPI Number | 1801007687
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Entity Type | Organization
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Legal Business Name | NEURO LOGIC CARE, L.L.C.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 11/29/2017
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Provider Practice Location Address
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Address Line | 5 PERRYRIDGE RD
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City | GREENWICH
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State | CT
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Zip | 06830-4608
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Country | US
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Telephone | 203-253-2644
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Fax | 914-253-8099
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Provider Business Mailing Address
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Address Line | 170 CLAPBOARD RIDGE RD
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City | GREENWICH
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State | CT
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Zip | 06831-3351
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Country | US
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Telephone | 203-253-2644
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Fax | 914-253-8099
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES R MORRIS
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Credential | M.D.
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Telephone | 914-253-8011
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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 | 187992
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 035215
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License Number State | CT
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