Provider Demographics
NPI:1932466729
Name:NEUROLOGY PSYCHIATRY AND BALANCE THERAPY CENTER LLC
Entity Type:Organization
Organization Name:NEUROLOGY PSYCHIATRY AND BALANCE THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-591-0700
Mailing Address - Street 1:725 SKIPPACK PIKE
Mailing Address - Street 2:PAREC PLAZA, SUITE 130
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1704
Mailing Address - Country:US
Mailing Address - Phone:215-591-0700
Mailing Address - Fax:
Practice Address - Street 1:725 SKIPPACK PIKE
Practice Address - Street 2:PAREC PLAZA, SUITE 130
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1704
Practice Address - Country:US
Practice Address - Phone:215-591-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2084N0400X, 2084P0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty