Provider Demographics
NPI:1003477324
Name:OVERLOOK NEUROLOGY, LLC
Entity Type:Organization
Organization Name:OVERLOOK NEUROLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-260-3736
Mailing Address - Street 1:1653 LITITZ PIKE # 1067
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6507
Mailing Address - Country:US
Mailing Address - Phone:717-260-3736
Mailing Address - Fax:
Practice Address - Street 1:211 PAULINE DR # 1021
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4637
Practice Address - Country:US
Practice Address - Phone:717-260-3736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Multi-Specialty