Livingspring Neurology Center Llc | |
109 Harrigan Way Yorktown VA 23693-5609 | |
(757) 598-2123 | |
Not Available |
Full Name | Livingspring Neurology Center Llc |
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Speciality | Psychiatry & Neurology |
Location | 109 Harrigan Way, Yorktown, Virginia |
Authorized Official Name and Position | Olubusola Amiola (PROVIDER) |
Authorized Official Contact | 7575982123 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Livingspring Neurology Center Llc 109 Harrigan Way Yorktown VA 23693-5609 Ph: (757) 598-2123 | Livingspring Neurology Center Llc 109 Harrigan Way Yorktown VA 23693-5609 Ph: (757) 598-2123 |
NPI Number | 1093581399 |
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Provider Enumeration Date | 11/28/2023 |
Last Update Date | 11/28/2023 |
Certification Date | 11/28/2023 |
Medicare PECOS PAC ID | 6204272834 |
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Medicare Enrollment ID | O20240306000924 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093581399 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Secondary |
Provider Name | Olubusola Amiola |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1437503323 PECOS PAC ID: 6305162041 Enrollment ID: I20210614001797 |
Provider Name | Tolulope O Amiola |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1952807463 PECOS PAC ID: 9234513425 Enrollment ID: I20230915000922 |
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