Organization
NEUROLOGY PA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHLA VAKILI MD (MD)
(610) 331-6942
Entity
Organization
Contact information
Practice address
1500 LOCUST ST, 4406, PHILADELPHIA, PA 19102-4329
(610) 331-6942
(215) 875-8324
Mailing address
PO BOX 42313, PHILADELPHIA, PA 19101-2313
(610) 331-6942
(215) 875-8324
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1860
DE
261QM2500X
Medical Specialty Clinic/Center
MD
PA
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/23/2008
Last updated
09/03/2008
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