Provider Demographics
NPI:1134159882
Name:INTERPRETIVE NEURODIAGNOSTICS LLC
Entity type:Organization
Organization Name:INTERPRETIVE NEURODIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCCARREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-489-6803
Mailing Address - Street 1:555 2ND AVE
Mailing Address - Street 2:SUITE C-850
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3600
Mailing Address - Country:US
Mailing Address - Phone:610-489-6803
Mailing Address - Fax:610-489-6761
Practice Address - Street 1:555 2ND AVE
Practice Address - Street 2:SUITE C-850
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3600
Practice Address - Country:US
Practice Address - Phone:610-489-6803
Practice Address - Fax:610-489-6761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA067381Medicare PIN