| Gni Neuro Critical Care Llc | |
|
One Medical Center Blvd. Acp, Suite 232 Chester PA 19013-3902 | |
| (844) 464-6387 | |
| (215) 239-3037 |
| Full Name | Gni Neuro Critical Care Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | One Medical Center Blvd., Chester, Pennsylvania |
| Authorized Official Name and Position | S. Ausim Azizi (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8444646387 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gni Neuro Critical Care Llc One Medical Center Blvd. Acp, Suite 232 Chester PA 19013-3902 Ph: (844) 464-6387 | Gni Neuro Critical Care Llc One Medical Center Blvd. Acp, Suite 232 Chester PA 19013-3902 Ph: (844) 464-6387 |
| NPI Number | 1689227076 |
|---|---|
| Provider Enumeration Date | 07/24/2019 |
| Last Update Date | 04/24/2020 |
| Certification Date | 04/24/2020 |
| Medicare PECOS PAC ID | 1658601208 |
|---|---|
| Medicare Enrollment ID | O20190924002219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689227076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A2900X | Psychiatry & Neurology - Neurocritical Care | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Sayed Ausim Azizi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306834387 PECOS PAC ID: 9638083678 Enrollment ID: I20031125000033 |
| Provider Name | Stan Naydin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811377898 PECOS PAC ID: 9032442405 Enrollment ID: I20190618000914 |
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