Provider Demographics
NPI:1093096604
Name:STROKE AND CEREBROVASCULAR CENTER OF NEW JERSEY
Entity Type:Organization
Organization Name:STROKE AND CEREBROVASCULAR CENTER OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEURSURGERY CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EROL
Authorized Official - Middle Name:
Authorized Official - Last Name:VEZNEDAROGLU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-588-5081
Mailing Address - Street 1:1401 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3835
Mailing Address - Country:US
Mailing Address - Phone:609-588-5081
Mailing Address - Fax:609-588-5086
Practice Address - Street 1:1401 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 212
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3835
Practice Address - Country:US
Practice Address - Phone:609-588-5081
Practice Address - Fax:609-588-5086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00331200363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty