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General NPI Number Information
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NPI Number | 1770653909
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Entity Type | Organization
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Legal Business Name | ADULT NEUROLOGY CENTER, PC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 03/16/2020
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Provider Practice Location Address
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Address Line | 1025 JEFFERSON AVE
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City | WASHINGTON
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State | PA
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Zip | 15301-2119
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Country | US
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Telephone | 724-229-6195
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Fax | 724-229-6199
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Provider Business Mailing Address
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Address Line | 1025 JEFFERSON AVE
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City | WASHINGTON
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State | PA
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Zip | 15301-2119
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Country | US
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Telephone | 724-229-6195
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Fax | 724-229-6199
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE MICHAEL COTUGNO
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Credential | M.D.
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Telephone | 724-229-6198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD049746L
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License Number State | PA
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