Provider Demographics
NPI:1225600398
Name:HUNTERDON NEUROLOGY, PA
Entity Type:Organization
Organization Name:HUNTERDON NEUROLOGY, PA
Other - Org Name:HUNTERDON NEUROLOGY,PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:B
Authorized Official - Last Name:VIRADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-894-7222
Mailing Address - Street 1:6 MORNINGSIDE CT
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5950
Mailing Address - Country:US
Mailing Address - Phone:908-240-2483
Mailing Address - Fax:908-894-7128
Practice Address - Street 1:1322 STATE ROUTE 31 N STE 2
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3127
Practice Address - Country:US
Practice Address - Phone:908-894-7222
Practice Address - Fax:908-894-7128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPENDINGMedicaid