Provider Demographics
NPI:1104300300
Name:NOVA NEUROSCIENCES LLC
Entity type:Organization
Organization Name:NOVA NEUROSCIENCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANIAL
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:MCDOANLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-573-2942
Mailing Address - Street 1:3022 WILLIAMS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4600
Mailing Address - Country:US
Mailing Address - Phone:703-349-5223
Mailing Address - Fax:703-562-7966
Practice Address - Street 1:3022 WILLIAMS DR STE 100
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4600
Practice Address - Country:US
Practice Address - Phone:703-349-5223
Practice Address - Fax:703-562-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty