Provider Demographics
NPI:1477352698
Name:NEURO DEVELOPMENTAL SLEEP PLLC
Entity type:Organization
Organization Name:NEURO DEVELOPMENTAL SLEEP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-898-0430
Mailing Address - Street 1:3327 N EAGLE RD STE 110-129
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6141
Mailing Address - Country:US
Mailing Address - Phone:760-898-0430
Mailing Address - Fax:
Practice Address - Street 1:8601 W EMERALD ST STE 176
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8297
Practice Address - Country:US
Practice Address - Phone:208-793-7006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty