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General NPI Number Information
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NPI Number | 1851937981
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Entity Type | Organization
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Legal Business Name | NEURODIAGNOSTICS, INC.
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 12441 PARKLAWN DR STE 2A
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City | ROCKVILLE
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State | MD
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Zip | 20852-2180
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Country | US
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Telephone | 301-294-7026
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Fax |
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Provider Business Mailing Address
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Address Line | 12441 PARKLAWN DR STE 2A
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City | ROCKVILLE
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State | MD
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Zip | 20852-2180
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Country | US
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Telephone | 301-294-7026
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Fax | 301-576-8629
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Authorized Official
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Title or Position | OWNER
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Name | PAUL P. TANICO
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Credential |
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Telephone | 301-294-7026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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