| Neurological Group, Pc | |
|
350 Montauk Ave New London CT 06320-4730 | |
| (860) 443-1891 | |
| (860) 443-2980 |
| Full Name | Neurological Group, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 350 Montauk Ave, New London, Connecticut |
| Authorized Official Name and Position | Laurence I Radin (MANAGING PARTNER) |
| Authorized Official Contact | 8604431891 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurological Group, Pc 350 Montauk Ave New London CT 06320-4730 Ph: (860) 443-1891 | Neurological Group, Pc 350 Montauk Ave New London CT 06320-4730 Ph: (860) 443-1891 |
| NPI Number | 1336112267 |
|---|---|
| Provider Enumeration Date | 02/10/2006 |
| Last Update Date | 09/12/2007 |
| Medicare PECOS PAC ID | 6002894847 |
|---|---|
| Medicare Enrollment ID | O20040709000095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336112267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Andrea Stewart Lauter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457490070 PECOS PAC ID: 0244334852 Enrollment ID: I20070409000146 |
| Provider Name | Laurence I Radin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508860156 PECOS PAC ID: 0143208991 Enrollment ID: I20100224000354 |
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