| Neuroscience Institute Of Kentucky Llc | |
|
112 S Main St Ste A Somerset KY 42501-2063 | |
| (606) 744-1614 | |
| Not Available |
| Full Name | Neuroscience Institute Of Kentucky Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 112 S Main St Ste A, Somerset, Kentucky |
| Authorized Official Name and Position | Bruce Ballet (CAO) |
| Authorized Official Contact | 8607710622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuroscience Institute Of Kentucky Llc 112 S Main St Ste A Somerset KY 42501-2063 Ph: (606) 744-1614 | Neuroscience Institute Of Kentucky Llc 112 S Main St Ste A Somerset KY 42501-2063 Ph: (606) 744-1614 |
| NPI Number | 1316662679 |
|---|---|
| Provider Enumeration Date | 10/10/2022 |
| Last Update Date | 10/20/2022 |
| Certification Date | 10/20/2022 |
| Medicare PECOS PAC ID | 3375912389 |
|---|---|
| Medicare Enrollment ID | O20221214002356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316662679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | George Abraham Khouri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609138866 PECOS PAC ID: 4587987268 Enrollment ID: I20201209003207 |
| Provider Name | Justin A Canter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194274100 PECOS PAC ID: 2961783964 Enrollment ID: I20210506001806 |
| Provider Name | Jason John Madey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245466937 PECOS PAC ID: 2062791569 Enrollment ID: I20220209001205 |
| Provider Name | Usha Aryal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073712287 PECOS PAC ID: 2163657362 Enrollment ID: I20220322000420 |
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