Provider Demographics
NPI:1972558997
Name:COMPREHENSIVE NEUROLOGIC ASSOCIATES, PC
Entity Type:Organization
Organization Name:COMPREHENSIVE NEUROLOGIC ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MATARESE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-741-9555
Mailing Address - Street 1:680 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1817
Mailing Address - Country:US
Mailing Address - Phone:215-741-9555
Mailing Address - Fax:
Practice Address - Street 1:680 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1817
Practice Address - Country:US
Practice Address - Phone:215-741-9555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACH0208OtherRAILROAD MEDICARE
PA611728OtherPA HIGHMARK BLUE SHIELD
PA118039000OtherUS WORKER'S COMPENSATION
PA0439846000OtherINDEPENDENCE BLUE CROSS
PA47300OtherKEYSTONE MERCY
PA09159OtherHEALTH PARTNERS
PA47300OtherKEYSTONE MERCY