East Bay Neurology Professional Corporation
LBN: East Bay Neurology Professional Corporation
East Bay Neurology Professional Corporation is an health care organization with primary practice located at 333 School St Ste 216 , Pawtucket RI 02860. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is the primary health care specialty.
East Bay Neurology Professional Corporation can be contacted via phone (401) 722-7300, or through Al Yacoub, Motasem A via phone (401) 724-4100.
Contact Information
Primary practice address
333 School St Ste 216
Pawtucket RI 02860
Phone: (401) 722-7300
Fax: (401) 722-7390
Website:
Authorized official contact:
Name: Al Yacoub, Motasem A Doctor of Medicine (MD)
Phone: (401) 724-4100
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | PS00999 | Rhode Island |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | MD 09501 | Rhode Island |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 212368 | Massachusetts |
Profile Details
| NPI number | 1275668006 |
|---|---|
| LBN Legal business name | East Bay Neurology Professional Corporation |
| DBA Doing business as | |
| Authorized official | Al Yacoub, Motasem A Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | Jun 20th, 2018 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275668006 | NPPES |
| Rhode Island | MEDICAID | 7006029 |
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