Provider Demographics
NPI:1902877046
Name:NEUROLOGY SERVICES, INCORPORATED
Entity type:Organization
Organization Name:NEUROLOGY SERVICES, INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERNAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-878-0600
Mailing Address - Street 1:2296 OPITZ BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3300
Mailing Address - Country:US
Mailing Address - Phone:703-878-0600
Mailing Address - Fax:703-878-3747
Practice Address - Street 1:2296 OPITZ BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3300
Practice Address - Country:US
Practice Address - Phone:703-878-0600
Practice Address - Fax:703-878-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA990018952084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA130013905OtherRAILROAD MEDICARE
VA6195806Medicaid
MD219291801Medicaid
VAC07032Medicare ID - Type UnspecifiedVA AREA MEDICARE #
VA6195806Medicaid