Provider Demographics
NPI:1154627073
Name:METROPOLITAN NEUROPSYCHOLOGICAL CONSULTING P.C.
Entity Type:Organization
Organization Name:METROPOLITAN NEUROPSYCHOLOGICAL CONSULTING P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-757-6707
Mailing Address - Street 1:1530 PALISADE AVE
Mailing Address - Street 2:#25C
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5471
Mailing Address - Country:US
Mailing Address - Phone:917-757-0381
Mailing Address - Fax:
Practice Address - Street 1:440 WEST ST
Practice Address - Street 2:SUITE 302
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024
Practice Address - Country:US
Practice Address - Phone:917-757-6707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI4788103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty