Unknown Individual – Neurology Physician, NPI 1679670129

Neurology Physician

Unknown Individual is a healthcare provider. based in Willow grove, Pennsylvania. specializing in Neurology Physician. They hold a License No. MD033250-E (PA). The NPI Number for Unknown Individual is 1679670129

Main info

Organization

Inactive

52 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1679670129

Phone

(215) 957-9250

Address

2325 MARYLAND RD

Deactivation Date

24 August 2021

Doctor Profile

Medical School Name

UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY

Secondary Phone

2159579250

Graduation Year

1974 (52 years ago)

PAC ID

5496659146

Group Practice PAC ID

3274518444

Professional Enrollment ID

I20031124000475

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

Willow Grove, Worcester County, Maryland, United States
SUITE 120
WILLOW GROVE, PA 190901749
Phone: (215) 957-9250
Fax: (215) 957-9254
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19090)

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Provider's Procedures

Unknown Individual performs procedures in Neurology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
NEUROLOGY	PA	95910	Nerve transmission studies, 7-8 studies	16	16

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 3274518444View full group profile

Name	Specialty	State
KANDAN KULANDAIVEL (M.D.)	N E U R O L O G Y	PA
MS. IRINA URITSKY (MSN, CRNP)	-	PA
JOHN SAFA KHOURY (M.D.)	N E U R O L O G Y	PA
DAVID C WEISMAN (M.D.)	N E U R O L O G Y	PA
DR. MIN SOO KIM (M.D.)	N E U R O L O G Y	MO
DIANA LI (MD)	N E U R O L O G Y	NY
DR. DAN JONATHAN GZESH (MD)	N E U R O L O G Y	PA
LEE JAMES HARRIS (M.D.)	N E U R O L O G Y	PA
BRAD CRAIG KLEIN (M.D.)	N E U R O L O G Y	PA
JAMES HUNTER COOK (M.D.)	N E U R O L O G Y	PA