Provider Demographics
NPI:1104334796
Name:NEUROANALYTICS LLC
Entity type:Organization
Organization Name:NEUROANALYTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:ALANA
Authorized Official - Last Name:PERRIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:267-282-1395
Mailing Address - Street 1:121 N WAYNE AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3542
Mailing Address - Country:US
Mailing Address - Phone:267-282-1395
Mailing Address - Fax:267-573-3195
Practice Address - Street 1:121 N WAYNE AVE STE 303
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3542
Practice Address - Country:US
Practice Address - Phone:267-282-1395
Practice Address - Fax:267-573-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018040261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)