Provider Demographics
NPI:1083832018
Name:CHESTER COUNTY NEUROLOGY, LLC
Entity Type:Organization
Organization Name:CHESTER COUNTY NEUROLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAPLEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-345-1080
Mailing Address - Street 1:1011 WEST BALTIMORE PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9447
Mailing Address - Country:US
Mailing Address - Phone:610-345-1080
Mailing Address - Fax:610-345-1081
Practice Address - Street 1:1011 WEST BALTIMORE PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9447
Practice Address - Country:US
Practice Address - Phone:610-345-1080
Practice Address - Fax:610-345-1081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0504899000OtherPERSONAL CHOICE
PA2110236000OtherKEYSTONE HEALTH PLAN EAST
PA0019073910001Medicaid
PA0019073910001Medicaid