Healthcare Provider Details

I. General information

NPI: 1982626818
Provider Name (Legal Business Name): NEIL ANAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 YORK RD STORE FRONT
WILLOW GROVE PA
19090-2621
US

IV. Provider business mailing address

359 YORK RD STORE FRONT
WILLOW GROVE PA
19090-2621
US

V. Phone/Fax

Practice location:
  • Phone: 215-366-7141
  • Fax: 215-933-3120
Mailing address:
  • Phone: 215-366-7141
  • Fax: 215-933-3120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD422681
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD422681
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: