| Neurology And Pain Medical Associates Llc | |
|
130 Professional Ct Ste D Lafayette IN 47905-5153 | |
| (765) 446-8888 | |
| (219) 866-7001 |
| Full Name | Neurology And Pain Medical Associates Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 130 Professional Ct Ste D, Lafayette, Indiana |
| Authorized Official Name and Position | Julian Ungar-sargon (OWNER) |
| Authorized Official Contact | 2198667222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology And Pain Medical Associates Llc 123 S Mckinley Ave Rensselaer IN 47978-2949 Ph: (219) 866-7222 | Neurology And Pain Medical Associates Llc 130 Professional Ct Ste D Lafayette IN 47905-5153 Ph: (765) 446-8888 |
| NPI Number | 1265996144 |
|---|---|
| Provider Enumeration Date | 01/25/2019 |
| Last Update Date | 06/09/2021 |
| Certification Date | 06/09/2021 |
| Medicare PECOS PAC ID | 5496084022 |
|---|---|
| Medicare Enrollment ID | O20190907000135 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265996144 | NPI | - | NPPES |
| 01040129A | Other | IN | MEDICAL LICESNE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 208VP0000X | Pain Medicine - Pain Medicine | (* (Not Available)) | Secondary |
| Provider Name | Julian Y Ungar-sargon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376642900 PECOS PAC ID: 4880593144 Enrollment ID: I20040106000222 |
| Provider Name | Reba J Mahaffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215072715 PECOS PAC ID: 3375519614 Enrollment ID: I20040908000492 |
| Provider Name | Becky Hannowsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669681128 PECOS PAC ID: 9234388208 Enrollment ID: I20121008000183 |
| Provider Name | Bobby Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457891806 PECOS PAC ID: 1759650963 Enrollment ID: I20190521003514 |
| Provider Name | George Abraham Khouri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609138866 PECOS PAC ID: 4587987268 Enrollment ID: I20230623001514 |
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