Healthcare Provider Details

I. General information

NPI: 1326170515
Provider Name (Legal Business Name): NCV DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 01/29/2023
Certification Date: 01/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 BALTIMORE PIKE
SPRINGFIELD PA
19064-3954
US

IV. Provider business mailing address

891 BALTIMORE PIKE
SPRINGFIELD PA
19064-3954
US

V. Phone/Fax

Practice location:
  • Phone: 215-789-6264
  • Fax: 215-754-4695
Mailing address:
  • Phone: 215-789-6264
  • Fax: 215-754-4695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN GROSSINGER
Title or Position: OWNER
Credential: DO
Phone: 215-789-6264