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General NPI Number Information
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NPI Number | 1972838498
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Entity Type | Organization
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Legal Business Name | NEUROLOGY ASSOCIATES OF SUFFOLK, PLLC
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Dates
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Enumeration Date | 10/16/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5839 HARBOUR VIEW BLVD STE 201
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City | SUFFOLK
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State | VA
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Zip | 23435-3797
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Country | US
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Telephone | 757-967-0406
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Fax | 757-967-0675
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Provider Business Mailing Address
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Address Line | 150 BURNETTS WAY SUITE 320
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City | SUFFOLK
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State | VA
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Zip | 23434-8168
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Country | US
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Telephone | 757-934-1900
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Fax | 757-925-6719
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KIMBERLY HOLLAND GOLDEN
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Credential |
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Telephone | 757-967-0406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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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 | 174400000X
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Taxonomy Name | Specialist
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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