Provider Demographics
NPI:1306184569
Name:NEUROPHYS DIAGNOSTICS
Entity Type:Organization
Organization Name:NEUROPHYS DIAGNOSTICS
Other - Org Name:NEUROPHYS DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-294-0612
Mailing Address - Street 1:8001 CASTOR AVE
Mailing Address - Street 2:338
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2701
Mailing Address - Country:US
Mailing Address - Phone:215-294-0612
Mailing Address - Fax:
Practice Address - Street 1:8001 CASTOR AVE
Practice Address - Street 2:338
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-2701
Practice Address - Country:US
Practice Address - Phone:215-294-0612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty