| Pima Neurology Inc | |
|
400 W Magee Rd Tucson AZ 85704-6438 | |
| (520) 638-5553 | |
| (520) 638-5543 |
| Full Name | Pima Neurology Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 400 W Magee Rd, Tucson, Arizona |
| Authorized Official Name and Position | Moeen Ud Din (PRESIDENT) |
| Authorized Official Contact | 5206385553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pima Neurology Inc 400 W Magee Rd Tucson AZ 85704-6438 Ph: (520) 638-5553 | Pima Neurology Inc 400 W Magee Rd Tucson AZ 85704-6438 Ph: (520) 638-5553 |
| NPI Number | 1174871917 |
|---|---|
| Provider Enumeration Date | 08/28/2012 |
| Last Update Date | 08/28/2012 |
| Medicare PECOS PAC ID | 9436300506 |
|---|---|
| Medicare Enrollment ID | O20121119000580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174871917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Moeen Din |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598712259 PECOS PAC ID: 4284651266 Enrollment ID: I20101104001337 |
| Provider Name | Barbara L Hanisch Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023361599 PECOS PAC ID: 9234381336 Enrollment ID: I20121219000291 |
| Provider Name | Polina M Samoylova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295211159 PECOS PAC ID: 5193079283 Enrollment ID: I20181107003584 |
| Provider Name | Theodore J Bollard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760069686 PECOS PAC ID: 3476943465 Enrollment ID: I20211206002818 |
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