Provider Demographics
NPI:1699053504
Name:DELAWARE VALLEY BRAIN AND SPINE CARE,LLC
Entity type:Organization
Organization Name:DELAWARE VALLEY BRAIN AND SPINE CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-741-3141
Mailing Address - Street 1:104 PHEASANT RUN STE 105
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3439
Mailing Address - Country:US
Mailing Address - Phone:215-741-3141
Mailing Address - Fax:215-741-3143
Practice Address - Street 1:104 PHEASANT RUN STE 105
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3439
Practice Address - Country:US
Practice Address - Phone:215-741-3141
Practice Address - Fax:215-741-3143
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRINCETON BRAIN & SPINE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-26
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207T00000X, 208100000X, 208VP0014X
PAMD053757207T00000X
PAMD426351207T00000X
PAMD438119207T00000X
PAMD447907207T00000X
PAMD435536207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty