1699261313 NPI number — NEUROPSYCHOLOGICAL AND PSYCHODIAGNOSTIC ASSESSMENT CENTER OF NJ

Table of content: MRS. CHERYL ANN WAPLES RPH (NPI 1639117302)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699261313 NPI number — NEUROPSYCHOLOGICAL AND PSYCHODIAGNOSTIC ASSESSMENT CENTER OF NJ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROPSYCHOLOGICAL AND PSYCHODIAGNOSTIC ASSESSMENT CENTER OF NJ
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:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1699261313
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 WOODCREST DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVINGSTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07039-3849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-454-5070
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 EAGLE ROCK AVE STE 148
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST HANOVER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07936-3168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
862-591-9819
Provider Business Practice Location Address Fax Number:
973-251-9007
Provider Enumeration Date:
07/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
ECHO
Authorized Official First Name:
JOYCE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
862-591-9819

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  35S100433000 , 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)





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