Provider Demographics
NPI:1265598700
Name:THE NEUROLOGY CENTER OF S DELAWARE PA
Entity type:Organization
Organization Name:THE NEUROLOGY CENTER OF S DELAWARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ALDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-628-7730
Mailing Address - Street 1:24488 SUSSEX HWY
Mailing Address - Street 2:UNIT 6
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-8470
Mailing Address - Country:US
Mailing Address - Phone:302-628-7730
Mailing Address - Fax:302-628-7791
Practice Address - Street 1:24488 SUSSEX HWY
Practice Address - Street 2:UNIT 6
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-8470
Practice Address - Country:US
Practice Address - Phone:302-628-7730
Practice Address - Fax:302-628-7791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000927202Medicaid
DE=========OtherBLUE CROSS BLUE SHIELD OF DELAWARE
DE=========OtherBLUE CROSS BLUE SHIELD OF DELAWARE
959762Medicare ID - Type Unspecified
G56115Medicare UPIN