Provider Demographics
NPI:1912025560
Name:NEW CASTLE NEUROLOGY LLC
Entity Type:Organization
Organization Name:NEW CASTLE NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMACHANDRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:TATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-657-3232
Mailing Address - Street 1:2602 WILMINGTON RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1537
Mailing Address - Country:US
Mailing Address - Phone:724-657-3232
Mailing Address - Fax:
Practice Address - Street 1:2602 WILMINGTON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1537
Practice Address - Country:US
Practice Address - Phone:724-657-3232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053340-L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016988180003Medicaid
PA1377650OtherBCBS PA
PA551704Medicare PIN