Provider Demographics
NPI:1942383153
Name:NEUROSURGERY ASSOCIATES, PA
Entity Type:Organization
Organization Name:NEUROSURGERY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:MAHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-428-0314
Mailing Address - Street 1:1306 N BROOM ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-4209
Mailing Address - Country:US
Mailing Address - Phone:302-571-9750
Mailing Address - Fax:302-571-0620
Practice Address - Street 1:111 W HIGH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5529
Practice Address - Country:US
Practice Address - Phone:302-571-9750
Practice Address - Fax:302-571-0620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1164520037OtherNPI-MAGDY I. BOULOS, MD
DE1447358338OtherNPI
MD1942383153OtherNPI
DEDA6621OtherRAILROAD MEDICARE
DE1902906860OtherNPI-TERESA KITKO, PA-C
DE1073611968OtherNPI-PAWAN RASTOGI, MD
DE1922109206OtherNPI-COLLEEN DAVIS, PA-C
DE1073611968OtherNPI-PAWAN RASTOGI, MD
DE1164520037OtherNPI-MAGDY I. BOULOS, MD