Neurosync Medical Group (Il), S.C.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

NEUROSYNC MEDICAL GROUP (IL), S.C.

Practice address

118 Washington St
Suite 14
Holliston, MA 01746

Phone

(855) 455-8500

NPI assigned

Nov 20, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kimberly E. Idoko

Title

Medical Director

Phone

(203) 887-9349

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1972378974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 WASHINGTON ST",
            "address_2": "SUITE 14",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "01746",
            "telephone_number": "609-828-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 WASHINGTON ST",
            "address_2": "SUITE 14",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "01746",
            "telephone_number": "855-455-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSYNC MEDICAL GROUP (IL), S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "IDOKO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "203-887-9349",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2081P0301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Miller
• Flavia Maione Moreira
• Rebecca N Morgan, LICSW
• Ashley Nicole Mulvaney, CCC-SLP
• Dana Kimberly Neitzel, MS, CGC
• Neurosync Medical Group (NJ), P.C.
• New England Post-Acute Medical Group PLLC
• New England Therapy Associates, LLC
• Heather Nguyen, DMD
• Sandra Bryant Niedzwiecki, M.S.W.

• Neurology Physician in Holliston, MA
• Providers in Holliston, MA by specialty
• Neurology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.