Healthcare Provider Details

I. General information

NPI: 1649544222
Provider Name (Legal Business Name): K AND R NEUROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 N 12TH ST
LEHIGHTON PA
18235
US

IV. Provider business mailing address

1705 THORNDALE RD
BREINIGSVILLE PA
18031-1278
US

V. Phone/Fax

Practice location:
  • Phone: 610-442-4436
  • Fax:
Mailing address:
  • Phone: 610-442-4436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD437119
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberMD437119
License Number StatePA

VIII. Authorized Official

Name: AHAMED KARIM
Title or Position: MD
Credential:
Phone: 610-824-2121