Provider Demographics
NPI:1023568615
Name:PARAGON NEUROMONITORING, LLC.
Entity Type:Organization
Organization Name:PARAGON NEUROMONITORING, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:VADEN
Authorized Official - Last Name:HEDGEPETH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-632-4925
Mailing Address - Street 1:220 MAIN ST
Mailing Address - Street 2:APT 202
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-1350
Mailing Address - Country:US
Mailing Address - Phone:973-837-6579
Mailing Address - Fax:
Practice Address - Street 1:220 MAIN ST
Practice Address - Street 2:APT 202
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1350
Practice Address - Country:US
Practice Address - Phone:973-837-6579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty