| Neurology-neurodiagnostic Center, S.c. | |
|
2025 W Oklahoma Ave Suite 120 Milwaukee WI 53215-4455 | |
| (414) 382-8960 | |
| (414) 382-8975 |
| Full Name | Neurology-neurodiagnostic Center, S.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2025 W Oklahoma Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Thulasiraman P Ravichandran (PRESIDENT) |
| Authorized Official Contact | 4143828960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology-neurodiagnostic Center, S.c. 2025 W Oklahoma Ave Suite 120 Milwaukee WI 53215-4455 Ph: (414) 382-8960 | Neurology-neurodiagnostic Center, S.c. 2025 W Oklahoma Ave Suite 120 Milwaukee WI 53215-4455 Ph: (414) 382-8960 |
| NPI Number | 1033164462 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 09/07/2007 |
| Medicare PECOS PAC ID | 1153419270 |
|---|---|
| Medicare Enrollment ID | O20071126000547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033164462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Thulasirman P Ravichandran |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861447906 PECOS PAC ID: 7618065731 Enrollment ID: I20071126000539 |
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