| Mid-atlantic Epilepsy & Sleep Center Llc | |
|
6410 Rockledge Dr Ste 610 Bethesda MD 20817-1844 | |
| (301) 530-9745 | |
| (301) 530-0046 |
| Full Name | Mid-atlantic Epilepsy & Sleep Center Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6410 Rockledge Dr Ste 610, Bethesda, Maryland |
| Authorized Official Name and Position | Marcelo Elias Lancman (DIRECTOR/PHYSICIAN) |
| Authorized Official Contact | 9144195575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-atlantic Epilepsy & Sleep Center Llc Po Box 782438 Philadelphia PA 19178-2438 Ph: (301) 530-9745 | Mid-atlantic Epilepsy & Sleep Center Llc 6410 Rockledge Dr Ste 610 Bethesda MD 20817-1844 Ph: (301) 530-9745 |
| NPI Number | 1528824836 |
|---|---|
| Provider Enumeration Date | 02/23/2024 |
| Last Update Date | 08/29/2024 |
| Certification Date | 08/29/2024 |
| Medicare PECOS PAC ID | 6608217773 |
|---|---|
| Medicare Enrollment ID | O20240508000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528824836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Pavel Klein |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770528648 PECOS PAC ID: 4789611419 Enrollment ID: I20050725000306 |
| Provider Name | Perry M Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831373059 PECOS PAC ID: 6002071149 Enrollment ID: I20120622000444 |
| Provider Name | Jonathan Ross |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194712208 PECOS PAC ID: 0547159758 Enrollment ID: I20171004000139 |
| Provider Name | Deidre Janelle Ammah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043553464 PECOS PAC ID: 5991004665 Enrollment ID: I20180711003089 |
| Provider Name | Amanda Pong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750583399 PECOS PAC ID: 3476629577 Enrollment ID: I20210421001448 |
| Provider Name | Alexander Ramos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023497872 PECOS PAC ID: 5294025359 Enrollment ID: I20210910000030 |
| Provider Name | Kimberly R Laurine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417595968 PECOS PAC ID: 3274998802 Enrollment ID: I20230503001413 |
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