Provider Demographics
NPI:1164627816
Name:INTEGRATED CENTER FOR NEUROPATHY
Entity Type:Organization
Organization Name:INTEGRATED CENTER FOR NEUROPATHY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINGERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-742-7033
Mailing Address - Street 1:8355 LORETTO AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-1830
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8355 LORETTO AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-1830
Practice Address - Country:US
Practice Address - Phone:215-742-7033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD064147L261QI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA189173Medicare UPIN