Provider Demographics
NPI:1043206899
Name:THE READING NECK AND SPINE CENTER
Entity Type:Organization
Organization Name:THE READING NECK AND SPINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BANCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-372-1140
Mailing Address - Street 1:1270 BROADCASTING RD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3203
Mailing Address - Country:US
Mailing Address - Phone:610-372-1140
Mailing Address - Fax:
Practice Address - Street 1:1270 BROADCASTING RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3203
Practice Address - Country:US
Practice Address - Phone:610-372-1140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065781L207XS0117X
PAPT002688E2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02660500OtherCAPITAL BLUE CROSS
PA744633OtherHIGHMARK BLUE SHIELD
PADA6715OtherRAILROAD MEDICARE
PA02660500OtherCAPITAL BLUE CROSS