Provider Demographics
NPI:1497776140
Name:TEMPLE NEUROLOGY
Entity Type:Organization
Organization Name:TEMPLE NEUROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-342-6481
Mailing Address - Street 1:7602 CENTRAL AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-2443
Mailing Address - Country:US
Mailing Address - Phone:215-342-6481
Mailing Address - Fax:215-722-2635
Practice Address - Street 1:7602 CENTRAL AVE
Practice Address - Street 2:STE 203
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2443
Practice Address - Country:US
Practice Address - Phone:215-342-6481
Practice Address - Fax:215-722-2635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty