Provider Demographics
NPI:1962594416
Name:CUMBERLAND VALLEY NEUROSURGICAL CONSULTS
Entity type:Organization
Organization Name:CUMBERLAND VALLEY NEUROSURGICAL CONSULTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING/BUSINESS MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NACE
Authorized Official - Suffix:
Authorized Official - Credentials:RMACMT
Authorized Official - Phone:717-263-3850
Mailing Address - Street 1:764 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2710
Mailing Address - Country:US
Mailing Address - Phone:717-263-3850
Mailing Address - Fax:717-263-3379
Practice Address - Street 1:764 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2710
Practice Address - Country:US
Practice Address - Phone:717-263-3850
Practice Address - Fax:717-263-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014430E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty