Provider Demographics
NPI:1851329643
Name:HERMITAGE NEUROLOGY PC
Entity Type:Organization
Organization Name:HERMITAGE NEUROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:AKRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-983-1015
Mailing Address - Street 1:PO BOX 1118
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148
Mailing Address - Country:US
Mailing Address - Phone:724-983-0840
Mailing Address - Fax:724-983-0841
Practice Address - Street 1:295 N KERRWOOD DR
Practice Address - Street 2:SUITE 103
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-5207
Practice Address - Country:US
Practice Address - Phone:724-983-1015
Practice Address - Fax:724-983-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2527260Medicaid
PA0019581760001Medicaid
OH2527260Medicaid