Provider Demographics
NPI:1194340414
Name:NORTHSTAR NEUROLOGY OF COLORADO SPRINGS PC
Entity type:Organization
Organization Name:NORTHSTAR NEUROLOGY OF COLORADO SPRINGS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:APARNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMATINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-694-3595
Mailing Address - Street 1:PO BOX 38670
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80937-8670
Mailing Address - Country:US
Mailing Address - Phone:719-694-3595
Mailing Address - Fax:719-493-9936
Practice Address - Street 1:3920 N UNION BLVD STE 150
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-1907
Practice Address - Country:US
Practice Address - Phone:719-694-3595
Practice Address - Fax:719-493-9936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty