| Neuroglee Health | |
|
221 1st Ave Sw Ste 610 Rochester MN 55902-4504 | |
| (857) 557-5777 | |
| (857) 557-5778 |
| Full Name | Neuroglee Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 221 1st Ave Sw Ste 610, Rochester, Minnesota |
| Authorized Official Name and Position | Ravi Patel (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3523138000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuroglee Health 101 Arch St Fl 8 Boston MA 02110-7500 Ph: (857) 557-5777 | Neuroglee Health 221 1st Ave Sw Ste 610 Rochester MN 55902-4504 Ph: (857) 557-5777 |
| NPI Number | 1336858232 |
|---|---|
| Provider Enumeration Date | 11/18/2022 |
| Last Update Date | 08/01/2024 |
| Certification Date | 08/01/2024 |
| Medicare PECOS PAC ID | 5698141240 |
|---|---|
| Medicare Enrollment ID | O20230106001585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336858232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Danielle J Koenig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841645942 PECOS PAC ID: 0547552689 Enrollment ID: I20160711000056 |
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