Organization
NEUROLOGY AND STROKE ASSOC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENKATACHALAM MANGESHKUMAR MD (OWNER)
(717) 569-8773
Entity
Organization
Contact information
Practice address
640 EAST OREGON ROAD, LITITZ, PA 17543
(717) 569-8773
(717) 569-8187
Mailing address
640 EAST OREGON ROAD, LITITZ, PA 17543
(717) 569-8773
(717) 569-8187
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2084N0400X
Neurology Physician
Primary
MD061259L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016722400
—
PA
Enumeration date
06/22/2006
Last updated
01/07/2010
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