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Contact Information

BRAIN MAPPING AND COMPUTERIZED NEUROPHSIOLOGY LABORATORY, INC
1 RANDALL SQ
SUITE 409
PROVIDENCE, RI02904-2709
 Phone: 401-274-5150
 Fax: 401-274-2130
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physiological Laboratory, (Independent Physiological Lab)

293D00000X 47 Independent Diagnostic Testing Facility (IDTF)
Indicates primary specialty

NPI Profile & details for BRAIN MAPPING AND COMPUTERIZED NEUROPHSIOLOGY LABORATORY, INC

NPI # 1720136419
LBN Legal business name BRAIN MAPPING AND COMPUTERIZED NEUROPHSIOLOGY LABORATORY, INC
Authorized official JEFFREY WISHIK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/08/2007
Last updated 10/03/2012 - About 14 years ago
Identifiers
RI Medicaid 9000330
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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