Brain Mapping and Computerized Neurophsiology Laboratory, INC

NPI #1720136419 in Providence, Rhode Island

Provider Information

NPI Number
1720136419
Entity Type
Organization
Organization Name
Brain Mapping and Computerized Neurophsiology Laboratory, INC
Primary Specialty
Physiological Laboratory
Enumeration Date
Jan 8, 2007
Last Updated
Oct 3, 2012

Practice Location

Address
1 RANDALL SQ
Address 2
SUITE 409
ZIP Code
02904-2709
Phone
(401) 274-5150

Authorized Official

Name
DR. JEFFREY M WISHIK, MD
Title
PRESIDENT
Phone
(401) 274-5150

Specialties & Taxonomy Codes

Specialty
Physiological Laboratory

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