Provider Demographics
NPI:1497064968
Name:NEURO DIAGNOSTIC CENTER PA
Entity Type:Organization
Organization Name:NEURO DIAGNOSTIC CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BAJAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-766-7303
Mailing Address - Street 1:325 HOSPITAL DR STE 104
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5806
Mailing Address - Country:US
Mailing Address - Phone:410-766-7303
Mailing Address - Fax:410-766-2514
Practice Address - Street 1:325 HOSPITAL DR STE 104
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5806
Practice Address - Country:US
Practice Address - Phone:410-766-7303
Practice Address - Fax:410-766-2514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE48152Medicare UPIN