Provider Demographics
NPI:1801649645
Name:ADVANCED NEURODIAGNOSTICS LLC
Entity type:Organization
Organization Name:ADVANCED NEURODIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRABINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:610-662-1583
Mailing Address - Street 1:1251 S CEDAR CREST BLVD STE 212B
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6214
Mailing Address - Country:US
Mailing Address - Phone:610-662-1583
Mailing Address - Fax:833-450-0378
Practice Address - Street 1:1251 S CEDAR CREST BLVD STE 212B
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6214
Practice Address - Country:US
Practice Address - Phone:610-662-1583
Practice Address - Fax:833-450-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Multi-Specialty