Provider Demographics
NPI:1831496694
Name:NEUROLOGY CENTER OF PHILADELPHIA INC
Entity Type:Organization
Organization Name:NEUROLOGY CENTER OF PHILADELPHIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:215-870-2551
Mailing Address - Street 1:2401 HOFFNAGLE ST APT A204
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2554
Mailing Address - Country:US
Mailing Address - Phone:215-870-2551
Mailing Address - Fax:
Practice Address - Street 1:501 BATH RD STE 201
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-3101
Practice Address - Country:US
Practice Address - Phone:215-870-2551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty