Provider Demographics
NPI:1356082754
Name:SUMMIT NEUROTHERAPY
Entity Type:Organization
Organization Name:SUMMIT NEUROTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSINA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:908-209-6842
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:908-209-6842
Mailing Address - Fax:
Practice Address - Street 1:11 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3501
Practice Address - Country:US
Practice Address - Phone:908-209-0684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service