Organization
ADVANCED NEUROLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY SHEPHARD M.D., MBA, HHP (ADMINISTRATOR)
(215) 574-3573
Entity
Organization
Contact information
Practice address
822 PINE ST, SUITE 3C, PHILADELPHIA, PA 19107-6187
(215) 574-3573
(215) 574-3645
Mailing address
822 PINE ST, SUITE 3C, PHILADELPHIA, PA 19107-6187
(215) 574-3573
(215) 574-3645
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821920
AETNA HMO
PA
01
—
2030376
HIGHMARK
PA
01
—
3504822000
PC/KHPE/IBC
PA
01
—
9015156
AETNA PPO
—
Enumeration date
03/13/2008
Last updated
01/22/2010
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