Provider Demographics
NPI:1215225529
Name:AFFILIATED NEUROLOGY A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:AFFILIATED NEUROLOGY A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-617-0808
Mailing Address - Street 1:23 KILMER DR
Mailing Address - Street 2:BLDG 1 SUITE E
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1563
Mailing Address - Country:US
Mailing Address - Phone:732-617-0808
Mailing Address - Fax:
Practice Address - Street 1:23 KILMER DR
Practice Address - Street 2:BLDG 1 SUITE E
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1563
Practice Address - Country:US
Practice Address - Phone:732-617-0808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty