Basic Information
| Provider Information | |||||||||
| NPI: | 1679715486 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARADISE | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 FOXFIELD CT | ||||||||
| Address2: | |||||||||
| City: | BEAR | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197014853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3028381089 | ||||||||
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| Practice Location | |||||||||
| Address1: | NEUROLOGY ASSOCIATES P.A. | ||||||||
| Address2: | 774 CHRISTIANA ROAD, SUITE 201 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027313017 | ||||||||
| FaxNumber: | 3022928115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2009 | ||||||||
| LastUpdateDate: | 03/26/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WN0800X | L1-0034103 | DE | Y | Nursing Service Providers | Registered Nurse | Neuroscience |
No ID Information.