Provider Demographics
NPI:1538851985
Name:NEUROCOGNITIVE TESTING LAB INC
Entity type:Organization
Organization Name:NEUROCOGNITIVE TESTING LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EFLAND
Authorized Official - Middle Name:H
Authorized Official - Last Name:AMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-450-8925
Mailing Address - Street 1:1188 BISHOP ST STE 2512
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3310
Mailing Address - Country:US
Mailing Address - Phone:808-450-8925
Mailing Address - Fax:808-200-7711
Practice Address - Street 1:1188 BISHOP ST STE 2512
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3310
Practice Address - Country:US
Practice Address - Phone:808-450-8925
Practice Address - Fax:808-200-7711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty