Provider Demographics
NPI:1447461512
Name:NEUROPHYS DIAGNOSTICS, INC.
Entity type:Organization
Organization Name:NEUROPHYS DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-385-6696
Mailing Address - Street 1:8001 CASTOR AVE
Mailing Address - Street 2:# 338
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2701
Mailing Address - Country:US
Mailing Address - Phone:267-385-6696
Mailing Address - Fax:267-385-6696
Practice Address - Street 1:8001 CASTOR AVE
Practice Address - Street 2:# 338
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-2701
Practice Address - Country:US
Practice Address - Phone:267-385-6696
Practice Address - Fax:267-385-6696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0400144277261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service