| Neuroglia Pllc | |
|
1525 S Higley Rd Ste 104 Gilbert AZ 85296-5045 | |
| (847) 913-4154 | |
| (480) 535-5858 |
| Full Name | Neuroglia Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1525 S Higley Rd Ste 104, Gilbert, Arizona |
| Authorized Official Name and Position | Surabhi Yeshwant Patwardhan (OWNER) |
| Authorized Official Contact | 8479134154 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuroglia Pllc 1525 S Higley Rd Ste 104 Gilbert AZ 85296-5045 Ph: (847) 913-4154 | Neuroglia Pllc 1525 S Higley Rd Ste 104 Gilbert AZ 85296-5045 Ph: (847) 913-4154 |
| NPI Number | 1952949380 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 12/16/2019 |
| Certification Date | 12/16/2019 |
| Medicare PECOS PAC ID | 7113352915 |
|---|---|
| Medicare Enrollment ID | O20200125000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952949380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Surabhi Y Patwardhan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164864161 PECOS PAC ID: 4486871894 Enrollment ID: I20140808000215 |
| Provider Name | Michelle C James |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841702743 PECOS PAC ID: 8921366535 Enrollment ID: I20180102002535 |
| Provider Name | Stephanie R Middaugh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699338863 PECOS PAC ID: 3779826169 Enrollment ID: I20190529000856 |
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