Neuro Source Diagnostics, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NEURO SOURCE DIAGNOSTICS, INC

Practice address

9276 Jamison Ave
Unit a
Philadelphia, PA 19115-4281

Phone

(215) 460-7475

Fax

(215) 677-2073

NPI assigned

Mar 24, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ryan RossienNPI 1053713925

Title

Owner

Phone

(215) 460-7475

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Rossien

  • Other Technician
  • Philadelphia, PA
  • NPI 1053713925
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395705600000",
    "number": "1083031496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 JAMISON AVE",
            "address_2": "UNIT A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154281",
            "telephone_number": "215-460-7475",
            "fax_number": "215-677-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9276 JAMISON AVE",
            "address_2": "UNIT A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154281",
            "telephone_number": "215-460-7475",
            "fax_number": "215-677-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO SOURCE DIAGNOSTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-25",
        "status": "A",
        "authorized_official_last_name": "ROSSIEN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-460-7475"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Neumann
• Samantha Neumann, DO
• Sulabh Neupane
• Neupath Physical Therapy LLC
• Neuro Dynamics Penn
• Neuro-Ophthalmologic Associates PC
• Neurodynamix Testing and Therapy Solutions PLLC
• Neuroflow
• Neurology and Neurophysiology Associates, P.C.
• Neurology Associates LTD

• Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.