Neurospine Associates PC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MD420830 Issued in PA

Legal business name

NEUROSPINE ASSOCIATES PC

Practice address

895 S Arlington Ave
Harrisburg, PA 17109-5004

Phone

(717) 727-7131

Fax

(717) 980-5147

NPI assigned

Feb 8, 2016

Last updated

Mar 3, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Devanand Anthony Dominique, MD

Title

Owner

Phone

(717) 727-7131

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488499200000",
    "number": "1366800120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 S ARLINGTON AVE",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095004",
            "telephone_number": "717-727-7131",
            "fax_number": "717-980-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 S ARLINGTON AVE",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095004",
            "telephone_number": "717-727-7131",
            "fax_number": "717-980-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSPINE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-08",
        "last_updated": "2017-03-03",
        "status": "A",
        "authorized_official_last_name": "DOMINIQUE",
        "authorized_official_first_name": "DEVANAND",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-727-7131",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD420830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1477541456",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurological Surgery Physician in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Neurological Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; 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.