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General NPI Number Information
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NPI Number | 1497776140
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Entity Type | Organization
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Legal Business Name | TEMPLE NEUROLOGY
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 7602 CENTRAL AVE STE 203
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2443
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Country | US
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Telephone | 215-342-6481
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Fax | 215-722-2635
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Provider Business Mailing Address
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Address Line | 7602 CENTRAL AVE STE 203
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2443
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Country | US
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Telephone | 215-342-6481
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Fax | 215-722-2635
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DONNA M MILLER
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Credential |
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Telephone | 215-342-6481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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