MEDICARE: GROSSINGER NEUROPAIN SPECIALISTS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	PA
2	101YP2500X	Professional Counselor	PA
3	2084N0400X	Neurology Physician	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558391821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROSSINGER NEUROPAIN SPECIALISTS PC

Provider Business Mailing Address
First Line	:	1510 CHESTER PIKE
Second Line	:	SUITE 130
City	:	EDDYSTONE
State	:	PA
Zip	:	19022-1375
Country	:	US
Telephone Number	:	610-521-6063
Fax Number	:	610-521-0163

Provider Business Practice Location Address
First Line	:	1510 CHESTER PIKE
Second Line	:	SUITE 130
City	:	EDDYSTONE
State	:	PA
Zip	:	19022-1375
Country	:	US
Telephone Number	:	610-521-6063
Fax Number	:	610-521-0163

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	BLANCHE DONATO
Credential	:
Telephone Number	:	610-521-6063

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	05/22/2014

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