Basic Information
| Provider Information | |||||||||
| NPI: | 1669540662 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ARIZONA NEUROLOGICAL INSTITUTE, PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ARIZONA NEUROLOGY | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10474 W THUNDERBIRD BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853513015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239723800 | ||||||||
| FaxNumber: | 6239721089 | ||||||||
| Practice Location | |||||||||
| Address1: | 10474 W THUNDERBIRD BLVD | ||||||||
| Address2: | SUITE200 | ||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853513023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239723800 | ||||||||
| FaxNumber: | 6239721089 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 09/11/2014 | ||||||||
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| AuthorizedOfficialLastName: | SYAL | ||||||||
| AuthorizedOfficialFirstName: | ATUL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6239723800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | N | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Specialist | 208VP0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 208100000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2084N0400X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.