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General NPI Number Information
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NPI Number | 1801829619
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Entity Type | Organization
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Legal Business Name | NEUROLOGIC ARTS ASSOCIATED, LLC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/18/2011
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Provider Practice Location Address
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Address Line | 104 BENNETT AVE SUITE 2B
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City | MILFORD
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State | PA
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Zip | 18337-9759
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Country | US
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Telephone | 570-296-5188
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Fax | 570-296-2296
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Provider Business Mailing Address
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Address Line | 104 BENNETT AVE SUITE 2B
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City | MILFORD
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State | PA
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Zip | 18337-9759
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Country | US
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Telephone | 570-296-5188
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Fax | 570-296-2296
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BERNARD M WEINTRAUB
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Credential | M.D.
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Telephone | 570-296-5188
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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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