Provider Demographics
NPI:1821177015
Name:KC NEUROLOGY & ASSOCIATES, PC
Entity Type:Organization
Organization Name:KC NEUROLOGY & ASSOCIATES, PC
Other - Org Name:POCONO BALANCE AND DIZZINESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISION
Authorized Official - Prefix:
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KATARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-517-7373
Mailing Address - Street 1:3 PARKINSON'S ROAD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301
Mailing Address - Country:US
Mailing Address - Phone:570-517-7373
Mailing Address - Fax:570-517-7377
Practice Address - Street 1:3 PARKINSON'S ROAD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301
Practice Address - Country:US
Practice Address - Phone:570-517-7373
Practice Address - Fax:570-517-7377
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KC NEUROLOGY & ASSOCIATES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-06
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA196814Medicare PIN