Provider Demographics
NPI:1902112014
Name:NEURO-CONSULTANTS.PC
Entity Type:Organization
Organization Name:NEURO-CONSULTANTS.PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:UMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BASAVARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-745-2480
Mailing Address - Street 1:110 N ROBINSON ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4459
Mailing Address - Country:US
Mailing Address - Phone:804-612-8418
Mailing Address - Fax:804-612-8417
Practice Address - Street 1:110 N ROBINSON ST
Practice Address - Street 2:SUITE 204
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4459
Practice Address - Country:US
Practice Address - Phone:804-612-8418
Practice Address - Fax:804-612-8417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0195722261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty