Provider Demographics
NPI:1598816837
Name:COMMONWEALTH NEUROLOGY SERVICES, P.S.C.
Entity Type:Organization
Organization Name:COMMONWEALTH NEUROLOGY SERVICES, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:ZERGA
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:859-278-8499
Mailing Address - Street 1:1780 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1400
Mailing Address - Country:US
Mailing Address - Phone:859-278-8499
Mailing Address - Fax:859-278-8683
Practice Address - Street 1:1780 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1400
Practice Address - Country:US
Practice Address - Phone:859-278-8499
Practice Address - Fax:859-278-8683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY326522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65927311Medicaid
KY65927311Medicaid