MEDICARE: NEUROLOGICAL INSTITUTE OF WESTERN PENNSYLVANIA 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	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	:	1891787941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGICAL INSTITUTE OF WESTERN PENNSYLVANIA PC

Provider Business Mailing Address
First Line	:	433 FRYE FARM RD
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6480
Country	:	US
Telephone Number	:	724-537-0885
Fax Number	:	724-532-1931

Provider Business Practice Location Address
First Line	:	433 FRYE FARM RD
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6480
Country	:	US
Telephone Number	:	724-537-0885
Fax Number	:	724-532-1931

Authorized Official
Title or Position	:	MEDICAL SECRETARY
Name	:	MS. JACKIE LIPKO
Credential	:
Telephone Number	:	724-537-0885

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	12/11/2012

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