Organization
NEUROSERVICE OF PENNSYLVANIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RALEY M.D. (PRESIDENT)
(412) 226-3071
Entity
Organization
Contact information
Practice address
5990 UNIVERSITY BLVD, PMB # 198, MOON TOWNSHIP, PA 15108-4229
(412) 226-3071
Mailing address
5990 UNIVERSITY BLVD, PMB # 198, MOON TOWNSHIP, PA 15108-4229
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
04/25/2017
Last updated
05/04/2017
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