Provider Demographics
NPI:1033142104
Name:THE NEUROPSYCHIATRIC GROUP
Entity Type:Organization
Organization Name:THE NEUROPSYCHIATRIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:AGUILO-SEARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-277-5022
Mailing Address - Street 1:104 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3029
Mailing Address - Country:US
Mailing Address - Phone:610-277-5022
Mailing Address - Fax:610-277-5023
Practice Address - Street 1:104 EGYPT RD
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-3029
Practice Address - Country:US
Practice Address - Phone:610-277-5022
Practice Address - Fax:610-277-5023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2216948000OtherPERSONAL CHOICE
PA1397822OtherBLUE SHIELD
PA0019469990063Medicaid
PA486426000OtherMIS
PA2216948000OtherPERSONAL CHOICE
PA058546Medicare ID - Type UnspecifiedMEDICARE 2
PA058534Medicare PIN