Provider Demographics
NPI:1316219900
Name:PRINCETON NEUROLOGICAL SURGERY
Entity Type:Organization
Organization Name:PRINCETON NEUROLOGICAL SURGERY
Other - Org Name:BRAIN AND SPINE RADIOSURGERY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LIPANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:215-272-0834
Mailing Address - Street 1:7 WARNER ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-9226
Mailing Address - Country:US
Mailing Address - Phone:609-882-3100
Mailing Address - Fax:609-882-3400
Practice Address - Street 1:3836 QUAKERBRIDGE ROAD SUITE 203
Practice Address - Street 2:PRINCETON NEUROLOGICAL SURGER
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-890-3400
Practice Address - Fax:309-890-3410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08134300207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty