| New England Neurological - Bidco, Llc | |
|
21 Highland Ave Newburyport MA 01950-3872 | |
| (978) 687-2321 | |
| (978) 722-7287 |
| Full Name | New England Neurological - Bidco, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 21 Highland Ave, Newburyport, Massachusetts |
| Authorized Official Name and Position | Bruce Cook (CHAIRMAN OF THE BOARD) |
| Authorized Official Contact | 9786872321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New England Neurological - Bidco, Llc 354 Merrimack St Ste 1 Lawrence MA 01843-1755 Ph: (978) 687-2321 | New England Neurological - Bidco, Llc 21 Highland Ave Newburyport MA 01950-3872 Ph: (978) 687-2321 |
| NPI Number | 1154074367 |
|---|---|
| Provider Enumeration Date | 01/28/2022 |
| Last Update Date | 01/28/2022 |
| Certification Date | 01/28/2022 |
| Medicare PECOS PAC ID | 6204218548 |
|---|---|
| Medicare Enrollment ID | O20220802003467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154074367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Lanny Xue |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720101843 PECOS PAC ID: 6305927971 Enrollment ID: I20080122000126 |
| Provider Name | Benjamin Trachtman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528562758 PECOS PAC ID: 8628327533 Enrollment ID: I20220804000427 |
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