COMMUNITY NEUROLOGY ASSOCIATES PC

Provider Demographics

• NPI: 1205883782
• Name: COMMUNITY NEUROLOGY ASSOCIATES PC
• Entity type: Organization
• Organization Name: COMMUNITY NEUROLOGY ASSOCIATES PC
• Authorized Official - Title/Position: BILLING MANAGER
• Authorized Official - First Name: MELISSA
• Authorized Official - Middle Name: BETH
• Authorized Official - Last Name: TINKELMAN
• Authorized Official - Phone: 856-616-8777
• Mailing Address - Street 1: 100 SPRINGDALE RD
• Mailing Address - Street 2: A3 #412
• Mailing Address - City: CHERRY HILL
• Mailing Address - State: NJ
• Mailing Address - Zip Code: 08003-0000
• Mailing Address - Country: US
• Mailing Address - Phone: 856-616-8777
• Mailing Address - Fax: 856-616-8780
• Practice Address - Street 1: 100 SPRINGDALE RD
• Practice Address - Street 2: A3 #412
• Practice Address - City: CHERRY HILL
• Practice Address - State: NJ
• Practice Address - Zip Code: 08003-0000
• Practice Address - Country: US
• Practice Address - Phone: 856-616-8777
• Practice Address - Fax: 856-616-8780
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-05-28
• Last Update Date: 2008-04-20

Provider Licenses

State	License ID	Taxonomies
PA	MD045495M	2084N0400X
NJ	25MA06559700	2084N0400X
PA	MD062295L	2084N0400X
NJ	MD2500056788	2084N0400X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	2084N0400X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Neurology	Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
	33423367	Other	AETNA GROUP #
	3410492	Other	AETNA INDIV. PROV. #
	3738422	Other	AETNA INDIV. PROV #
	0437018000	Other	AMERIHEALTH PROVIDER #
PA	1561458	Other	BCBS GROUP #
	2255911000	Other	KEYSTONE/AMERIHEALTH GROU
	P3245151	Other	OXFORD HEALTH GROUP #
	P61458	Other	AMERIHEALTH GROUP #
	8547249	Other	CIGNA GROUP #
PA	T1954659	Other	BCBS INDIV. PROV #
PA	1561458	Other	BCBS GROUP #
	2255911000	Other	KEYSTONE/AMERIHEALTH GROU
NJ	089173	Medicare ID - Type Unspecified	PROVIDER'S LEGACY #
PA	076488	Medicare PIN
	P3245151	Other	OXFORD HEALTH GROUP #
	P00112647	Medicare ID - Type Unspecified	RAILROAD INDIV. PROV. #
	0437018000	Other	AMERIHEALTH PROVIDER #
NJ	=========	Other	BCBS GROUP #
	33423367	Other	AETNA GROUP #
	G54070	Medicare UPIN