Provider Demographics
NPI:1023055852
Name:SCRANTON NEUROLOGICAL ASSOCIATES PC
Entity type:Organization
Organization Name:SCRANTON NEUROLOGICAL ASSOCIATES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:REGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-348-3361
Mailing Address - Street 1:802 JEFFERSON AVENUE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1038
Mailing Address - Country:US
Mailing Address - Phone:570-348-1118
Mailing Address - Fax:570-348-1109
Practice Address - Street 1:802 JEFFERSON AVENUE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1038
Practice Address - Country:US
Practice Address - Phone:570-348-1118
Practice Address - Fax:570-348-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA673735Medicare ID - Type Unspecified