Provider Demographics
NPI:1528344942
Name:SUMMIT HEADACHE AND NEUROLOGIC INSTITUTE, PC
Entity type:Organization
Organization Name:SUMMIT HEADACHE AND NEUROLOGIC INSTITUTE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CORI
Authorized Official - Middle Name:MILLEN
Authorized Official - Last Name:SCHNUR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:720-336-4300
Mailing Address - Street 1:601 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 390
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3781
Mailing Address - Country:US
Mailing Address - Phone:720-336-4300
Mailing Address - Fax:720-833-9145
Practice Address - Street 1:601 E HAMPDEN AVE
Practice Address - Street 2:SUITE 390
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3781
Practice Address - Country:US
Practice Address - Phone:720-336-4300
Practice Address - Fax:720-833-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-30
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOAAA 3238Medicare PIN