MEDICARE: ADVANCED NEUROCARE, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	MD057359L	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	:	1730189234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED NEUROCARE, INC.

Provider Business Mailing Address
First Line	:	2525 9TH AVE
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-2014
Country	:	US
Telephone Number	:	814-949-3966
Fax Number	:	814-949-3969

Provider Business Practice Location Address
First Line	:	2525 9TH AVE
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-2014
Country	:	US
Telephone Number	:	814-949-3966
Fax Number	:	814-949-3969

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JOEL B YOUNGER
Credential	:	MD
Telephone Number	:	814-949-3966

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	08/22/2020

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