MEDICARE: ADULT NEUROLOGY CENTER, PC

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	174400000X	Specialist	MD049746L	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	:	1770653909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADULT NEUROLOGY CENTER, PC

Provider Business Mailing Address
First Line	:	1025 JEFFERSON AVE
Second Line	:
City	:	WASHINGTON
State	:	PA
Zip	:	15301-2119
Country	:	US
Telephone Number	:	724-229-6195
Fax Number	:	724-229-6199

Provider Business Practice Location Address
First Line	:	1025 JEFFERSON AVE
Second Line	:
City	:	WASHINGTON
State	:	PA
Zip	:	15301-2119
Country	:	US
Telephone Number	:	724-229-6195
Fax Number	:	724-229-6199

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRUCE MICHAEL COTUGNO
Credential	:	M.D.
Telephone Number	:	724-229-6198

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	03/16/2020

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