Provider Demographics
NPI:1356082374
Name:UNITED NEURO DIAGNOSTIC SERVICES, LLC
Entity Type:Organization
Organization Name:UNITED NEURO DIAGNOSTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CHIEF TECHNOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TEEJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOJOHK
Authorized Official - Suffix:
Authorized Official - Credentials:ABRET
Authorized Official - Phone:973-633-0700
Mailing Address - Street 1:401 HAMBURG TPKE STE 205
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2139
Mailing Address - Country:US
Mailing Address - Phone:973-633-0070
Mailing Address - Fax:973-633-0706
Practice Address - Street 1:401 HAMBURG TPKE STE 205
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2139
Practice Address - Country:US
Practice Address - Phone:973-633-0070
Practice Address - Fax:973-633-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1235426347OtherDR DANI KORYA