Provider Demographics
NPI:1871531210
Name:UNIVERSITY NEUROLOGISTS ASSOCIATION,INC
Entity type:Organization
Organization Name:UNIVERSITY NEUROLOGISTS ASSOCIATION,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-844-3192
Mailing Address - Street 1:5910 LANDERBROOK DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MAYFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6508
Mailing Address - Country:US
Mailing Address - Phone:440-684-5816
Mailing Address - Fax:440-449-1555
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1736
Practice Address - Country:US
Practice Address - Phone:216-844-3192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered364SN0800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeuroscienceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCN1398OtherRAILROAD MEDICARE
OH0891941Medicaid
OH0891941Medicaid
OHUN9245651Medicare ID - Type Unspecified