Provider Demographics
NPI:1639299837
Name:NEUROSURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT NEUROSURGICAL ASSOCIATES
Authorized Official - Prefix:
Authorized Official - First Name:MERYLEE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WERTHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-288-2343
Mailing Address - Street 1:5049 OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-2652
Mailing Address - Country:US
Mailing Address - Phone:215-288-2343
Mailing Address - Fax:215-288-9878
Practice Address - Street 1:5049 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-2652
Practice Address - Country:US
Practice Address - Phone:215-288-2343
Practice Address - Fax:215-288-9878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
50343OtherAETNA
PA0006865630001Medicaid
046129OtherHIGHMARK BCBS
0052209000OtherKEYSTONE EAST
50343OtherAETNA