Provider Demographics
NPI:1154326296
Name:NEONATAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NEONATAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZAUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-754-2555
Mailing Address - Street 1:PO BOX 32730
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06150-2730
Mailing Address - Country:US
Mailing Address - Phone:973-773-0100
Mailing Address - Fax:973-773-2101
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2555
Practice Address - Fax:973-754-2567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7127901Medicaid