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General NPI Number Information
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NPI Number | 1700954922
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Entity Type | Organization
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Legal Business Name | NEUROLOGY ASSOCIATES LTD
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 1514 WOLF ST
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City | PHILADELPHIA
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State | PA
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Zip | 19145-4441
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Country | US
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Telephone | 215-463-3349
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Fax | 215-463-0131
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Provider Business Mailing Address
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Address Line | 1514 WOLF ST
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City | PHILADELPHIA
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State | PA
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Zip | 19145-4441
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Country | US
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Telephone | 215-463-3349
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Fax | 215-463-0131
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. RITA GRISOLIA
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Credential |
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Telephone | 215-463-3349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD010079E
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License Number State | PA
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