MEDICARE: NEUROLOGY ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0600X	Clinical Neurophysiology Physician	57338	OH

General Provider Information

NPI Number	:	1437243664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGY ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	2960 MACK RD
Second Line	:	SUITE 201
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5373
Country	:	US
Telephone Number	:	513-829-1700
Fax Number	:	513-829-5333

Provider Business Practice Location Address
First Line	:	2960 MACK RD
Second Line	:	SUITE 201
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5373
Country	:	US
Telephone Number	:	513-829-1700
Fax Number	:	513-829-5333

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VIJAY RAJAN
Credential	:	M.D.
Telephone Number	:	513-829-1700

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	11/29/2010

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