Provider Demographics
NPI:1790859437
Name:EMG NEUROLOGY CENTER, INC
Entity Type:Organization
Organization Name:EMG NEUROLOGY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:V
Authorized Official - Last Name:DHADUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:717-270-8944
Mailing Address - Street 1:PO BOX 1573
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-1573
Mailing Address - Country:US
Mailing Address - Phone:717-270-8944
Mailing Address - Fax:717-270-8948
Practice Address - Street 1:815 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7445
Practice Address - Country:US
Practice Address - Phone:717-270-8944
Practice Address - Fax:717-270-8948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0051604L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID
=========OtherTAX ID
DH766472Medicare ID - Type Unspecified