Provider Demographics
NPI:1609559251
Name:PENNSYLVANIA NERVE AND MUSCLE TESTING PC
Entity Type:Organization
Organization Name:PENNSYLVANIA NERVE AND MUSCLE TESTING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-318-1304
Mailing Address - Street 1:1999 MARCUS AVE STE M15
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1023
Mailing Address - Country:US
Mailing Address - Phone:914-318-1304
Mailing Address - Fax:
Practice Address - Street 1:171 ROBIN WAY
Practice Address - Street 2:
Practice Address - City:LACKAWAXEN
Practice Address - State:PA
Practice Address - Zip Code:18435
Practice Address - Country:US
Practice Address - Phone:914-318-1304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty