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General NPI Number Information
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NPI Number | 1801195078
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Entity Type | Organization
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Legal Business Name | THE NEUROSCIENCE TEAM LLC
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Dates
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Enumeration Date | 03/27/2011
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 22 WEST RD SUITE 100
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City | TOWSON
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State | MD
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Zip | 21204-2326
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Country | US
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Telephone | 410-828-7792
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Fax | 410-828-5620
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Provider Business Mailing Address
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Address Line | 22 WEST RD SUITE 100
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City | TOWSON
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State | MD
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Zip | 21204-2326
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Country | US
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Telephone | 410-828-7792
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TAMAR B NEWMAN
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Credential | R.N.
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Telephone | 410-828-7792
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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 | 04445
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License Number State | MD
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