NEUROCOGNITIVE CENTER OF MICHIGAN INC. (NPI# 1700204328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700204328 |
| Entity Type | Organization |
| Organization Name | NEUROCOGNITIVE CENTER OF MICHIGAN INC. |
| Other Organization Name | NCOFM |
| Practice Address |
28800 Ryan Rd Suite 320 Warren MI 48092-4272 |
| Practice Telephone | 5865820500 |
| Practice Fax Number | 5866208113 |
| Mailing Telephone | 5865820500 |
| Mailing Fax Number | 5866208113 |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2014-04-01 |
| Authorized Official Name | MR. KARIM M ALTABBA (DIRECTOR) |
| Authorized Official Telephone | 5865820500 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 163W00000X | Registered Nurse | Nursing Service Providers | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| NCOFM | Other Name - Individual/Organization |
| Street Address |
28800 RYAN RD SUITE 320 |
| City | WARREN |
| State | MI |
| Zip Code | 48092-4272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710967815 | Gary G Gilyard | Orthopaedic Surgery | 28800 Ryan Rd, Suite 280, Warren, MI 48092-4272 | 2006-01-17 |
| 1982055943 | Melissa Wummel | Social Worker | 28800 Ryan Rd, Ste 320, Warren, MI 48092-4272 | 2016-06-30 |
| 1477920510 | Yasmin Keshavjee | Family Medicine | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2015-08-24 |
| 1033502224 | Neurocognitive Center of Michigan Group | Psychologist | 28800 Ryan Rd, Suite 300, Warren, MI 48092-4272 | 2015-03-11 |
| 1801207907 | Kathryn Aurand | Physician Assistant | 28800 Ryan Rd, Suite 280, Warren, MI 48092-4272 | 2014-05-12 |
| 1952721862 | Samantha Reichling | Specialist | 28800 Ryan Rd, Warren, MI 48092-4272 | 2014-04-17 |
| 1487081782 | Sara Louise Blomeling-deroo | Social Worker | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2013-10-01 |
| 1275872376 | Dima Sprague | Physician Assistant | 28800 Ryan Rd, Warren, MI 48092-4272 | 2013-02-08 |
| 1568712370 | Behavioral Infermiera Care Solutions Inc | Psychologist | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2012-09-19 |
| 1932455599 | Kaitlyn Elizabeth Hefferan | Physician Assistant | 28800 Ryan Rd, Warren, MI 48092-4272 | 2012-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881163186 | Katherine Byrd | Behavior Technician | 3691 East 11 Mile Rd., Warren, MI 48092 | 2018-11-15 |
| 1861980302 | Mark Paul Azzo | Home Health Aide | 27605 Walker Ave, Warren, MI 48092 | 2018-04-30 |
| 1144747130 | Joseph Galutan Estrada | Chiropractor | 4846 Marlow Dr, Warren, MI 48092 | 2017-08-29 |
| 1649669425 | Lawrence Mosurak IIi | Chiropractor | 6201 Chicago Road, Warren, MI 48092 | 2015-01-15 |
| 1174911713 | Kimberly A Ott | Nurse Practitioner | 28800 Ryan Rd Suite 320, Warren, MI 48092 | 2015-01-06 |
| 1487071999 | Michele Szandzik | Chiropractor | 2243 East 12 Mile Rd, Warren, MI 48092 | 2014-03-21 |
| 1962827311 | Mouradian Dental Center, D.d.s., P.C. | Dentist | 32500 Mound Rd., Mouradian Dental Center, D.d.s., P.C., Warren, MI 48092 | 2014-02-21 |
| 1639495930 | Debra Kay Wenneman | Physical Therapist | 28776 Ryan Rd, Warren, MI 48092 | 2010-04-12 |
| 1922332923 | Sonia Amirali Pethani | Physical Therapist | 2117 E. Eleven Mile Rd., Warren, MI 48092 | 2009-09-23 |
| 1881822237 | Michael Patrick Walsh | Orthopaedic Surgery | 28800 Ryan Rd Ste 310, Warren, MI 48092 | 2009-06-24 |
| Find all providers in zip 48092 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740651967 | John L. Harrington | Psychiatry & Neurology | 4 Second Ave. Apt. #2, Warren, PA 16365 | 2015-10-14 |
| 1952727323 | Shilin R Pandya | Psychiatry & Neurology | 27 Mountain Blvd Ste 3, Warren, NJ 07059-5605 | 2014-03-10 |
| 1376688770 | David Schwartz Md PC | Psychiatry & Neurology | 12434 12 Mile Road, Suite 204, Warren, MI 48093 | 2007-02-21 |
| 1730192832 | Anthony Petrilli | Psychiatry & Neurology | 27550 Schoenherr Rd, Suite 300, Warren, MI 48088-4798 | 2006-08-14 |
| 1578575106 | Chilakamarri Ramesh | Psychiatry & Neurology | 11900 E Twelve Mile Rd, Suite #111, Warren, MI 48093-3472 | 2006-08-12 |
| 1932110319 | Shin Jae Lee | Psychiatry & Neurology | 1400 Tod Ave Nw, Warren, OH 44485-2483 | 2006-08-10 |
| 1740206168 | Lily Ann Marie Tencza | Psychiatry & Neurology | 28000 Dequindre Rd, Warren, MI 48092-2468 | 2006-07-15 |
| 1780649921 | Eleanor Judith Kulis | Psychiatry & Neurology | 29856 Schoenherr Rd, Ste IIi, Warren, MI 48088 | 2006-04-19 |
| 1578528725 | Barb Thielman Beebe | Psychiatry & Neurology | 29856 Schoenherr Road, Suite IIi, Warren, MI 48093 | 2006-04-19 |
| 1144206087 | Brahmaiah Tandra | Psychiatry & Neurology | 8577 E Market St, Warren, OH 44484-2345 | 2005-12-22 |
| Find all providers in WARREN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.