Provider Demographics
NPI:1427082411
Name:K C NEUROLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:K C NEUROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHHABRIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-424-1102
Mailing Address - Street 1:3 PARKINSONS RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8087
Mailing Address - Country:US
Mailing Address - Phone:570-424-1102
Mailing Address - Fax:570-517-5853
Practice Address - Street 1:3 PARKINSONS RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8087
Practice Address - Country:US
Practice Address - Phone:570-424-1102
Practice Address - Fax:570-517-5853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001425347Medicaid
PA196814Medicare ID - Type UnspecifiedPROVIDER NUMBER