Provider Demographics
NPI:1316394778
Name:SUMMIT NEUROTHERAPY
Entity Type:Organization
Organization Name:SUMMIT NEUROTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSIINA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:908-233-9551
Mailing Address - Street 1:45 NOMAHEGAN DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1007
Mailing Address - Country:US
Mailing Address - Phone:908-233-9551
Mailing Address - Fax:
Practice Address - Street 1:111 QUIMBY ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2185
Practice Address - Country:US
Practice Address - Phone:908-233-9551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100346600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty