Provider Demographics
NPI:1962374215
Name:NEURO ANIMATION SRC
Entity type:Organization
Organization Name:NEURO ANIMATION SRC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM COO
Authorized Official - Prefix:
Authorized Official - First Name:GAURAV
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-758-8889
Mailing Address - Street 1:6530 W CAMPUS OVAL STE 160
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9454
Mailing Address - Country:US
Mailing Address - Phone:614-758-8889
Mailing Address - Fax:815-368-4094
Practice Address - Street 1:6530 W CAMPUS OVAL STE 160
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-9454
Practice Address - Country:US
Practice Address - Phone:614-758-8889
Practice Address - Fax:815-368-4094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center