| Huntsville Neuropsychiatric Services, Llc | |
|
2303 Old Wagon Rd Se Huntsville AL 35801-1369 | |
| (256) 604-0434 | |
| (256) 964-6725 |
| Full Name | Huntsville Neuropsychiatric Services, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2303 Old Wagon Rd Se, Huntsville, Alabama |
| Authorized Official Name and Position | Gagandeep Dhaliwal (MEMBER) |
| Authorized Official Contact | 2566040434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Huntsville Neuropsychiatric Services, Llc 2303 Old Wagon Rd Se Huntsville AL 35801-1369 Ph: (256) 604-0434 | Huntsville Neuropsychiatric Services, Llc 2303 Old Wagon Rd Se Huntsville AL 35801-1369 Ph: (256) 604-0434 |
| NPI Number | 1619239597 |
|---|---|
| Provider Enumeration Date | 06/15/2012 |
| Last Update Date | 06/15/2012 |
| Medicare PECOS PAC ID | 8820254782 |
|---|---|
| Medicare Enrollment ID | O20120720000147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619239597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | 24823 (Alabama) | Primary |
| Provider Name | Gagandeep S Dhaliwal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265407944 PECOS PAC ID: 2567403264 Enrollment ID: I20050512000526 |
| Provider Name | Brittany E Kesten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942776695 PECOS PAC ID: 0244575249 Enrollment ID: I20181219002759 |
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