Provider Demographics
NPI:1861939068
Name:VERTEBRAL NEURODIAGNOSTIC ASSOCIATES LLC
Entity type:Organization
Organization Name:VERTEBRAL NEURODIAGNOSTIC ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:ASIF
Authorized Official - Middle Name:
Authorized Official - Last Name:SATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, CNIM
Authorized Official - Phone:443-472-0497
Mailing Address - Street 1:7820 PARAGON CIR APT 113
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6546
Mailing Address - Country:US
Mailing Address - Phone:443-472-0497
Mailing Address - Fax:
Practice Address - Street 1:7820 PARAGON CIR APT 113
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6546
Practice Address - Country:US
Practice Address - Phone:443-472-0497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty