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General NPI Number Information
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NPI Number | 1689627648
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Entity Type | Organization
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Legal Business Name | PENN NEUROLOGIC ASSOCIATES
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 920 LAWN AVE THE SUMMIT
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City | SELLERSVILLE
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State | PA
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Zip | 18960-1560
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Country | US
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Telephone | 215-257-4900
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Fax | 215-257-6681
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Provider Business Mailing Address
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Address Line | 920 LAWN AVE THE SUMMIT
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City | SELLERSVILLE
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State | PA
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Zip | 18960-1560
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Country | US
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Telephone | 215-257-4900
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Fax | 215-257-6681
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RICHARD ALAN BUCKLER
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Credential | M.D.
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Telephone | 215-257-4900
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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 | MD040916E
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License Number State | PA
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