Provider Demographics
NPI:1598757585
Name:NEUROLOGIC CARE AND DIAGNOSTIC CENTER PC
Entity Type:Organization
Organization Name:NEUROLOGIC CARE AND DIAGNOSTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHHINDER
Authorized Official - Middle Name:P
Authorized Official - Last Name:BINNING
Authorized Official - Suffix:
Authorized Official - Credentials:MD MRCP
Authorized Official - Phone:610-363-1154
Mailing Address - Street 1:115 JOHN ROBERT THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2653
Mailing Address - Country:US
Mailing Address - Phone:601-363-1154
Mailing Address - Fax:610-363-2377
Practice Address - Street 1:115 JOHN ROBERT THOMAS DR
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2653
Practice Address - Country:US
Practice Address - Phone:601-363-1154
Practice Address - Fax:610-363-2377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2010-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036749E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018950110003Medicaid
PA2823859OtherAETNA
PA1379342OtherBLUE CROSS BLUE SHIELD
PA1379342OtherBLUE CROSS BLUE SHIELD
057165Medicare ID - Type Unspecified