1851098008 NPI number — CENTER FOR NEUROCOGNITIVE THERAPY, LLC

Table of content: (NPI 1851098008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851098008 NPI number — CENTER FOR NEUROCOGNITIVE THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR NEUROCOGNITIVE THERAPY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851098008
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1447
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD CLIFFS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07632-1447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-967-8425
Provider Business Mailing Address Fax Number:
201-967-8443

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
381 PARK STREET
Provider Second Line Business Practice Location Address:
SUITE 2B
Provider Business Practice Location Address City Name:
HACKENSACK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07601-4350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-968-5097
Provider Business Practice Location Address Fax Number:
201-464-2278
Provider Enumeration Date:
02/08/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GHACIBEH
Authorized Official First Name:
GEORGES
Authorized Official Middle Name:
Authorized Official Title or Position:
M.D.
Authorized Official Telephone Number:
201-968-5097

Provider Taxonomy Codes

  • Taxonomy code: 2084E0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084N0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084S0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)