1548684244 NPI number — NEUROLOGY CONSULTANTS OF NORTH JERSEY PROFESSIONAL ASSOCIATION

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 1548684244 NPI number — NEUROLOGY CONSULTANTS OF NORTH JERSEY PROFESSIONAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROLOGY CONSULTANTS OF NORTH JERSEY PROFESSIONAL ASSOCIATION
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:
1548684244
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
370 W PLEASANTVIEW AVE
Provider Second Line Business Mailing Address:
SUITE 2-299
Provider Business Mailing Address City Name:
HACKENSACK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07601-8004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-680-8400
Provider Business Mailing Address Fax Number:
973-680-8404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
194 BROAD ST
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
BLOOMFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07003-2606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-342-0066
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/16/2014

Additional Information

Authorized Official

Authorized Official Last Name:
IBRAHIM
Authorized Official First Name:
AYMAN
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
516-724-0863

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  25MB09396200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com