1134849631 NPI number — NEUROSURGICAL MONITORING ASSOCIATES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134849631 NPI number — NEUROSURGICAL MONITORING ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROSURGICAL MONITORING ASSOCIATES, 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:
1134849631
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 CENTRAL AVENUE
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
EAST ORANGE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
862-343-7278
Provider Business Mailing Address Fax Number:
862-930-3821

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 CENTRAL AVENUE
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
EAST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
862-343-7278
Provider Business Practice Location Address Fax Number:
862-930-3821
Provider Enumeration Date:
09/02/2022

Additional Information

Authorized Official

Authorized Official Last Name:
GIUNTA
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
NICHOLAS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
862-343-7278

Provider Taxonomy Codes

  • Taxonomy code: 246ZE0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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