Provider Demographics
NPI:1386656270
Name:INSTITUTE OF NEUROLOGY AND NEUROSURGERY AT SAINT BARNABAS
Entity Type:Organization
Organization Name:INSTITUTE OF NEUROLOGY AND NEUROSURGERY AT SAINT BARNABAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ORRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-322-7580
Mailing Address - Street 1:18 E 41ST ST
Mailing Address - Street 2:STE 1206
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6222
Mailing Address - Country:US
Mailing Address - Phone:212-725-8511
Mailing Address - Fax:212-726-7417
Practice Address - Street 1:200 S ORANGE AVE
Practice Address - Street 2:STE 101
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5817
Practice Address - Country:US
Practice Address - Phone:973-322-7580
Practice Address - Fax:973-322-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7935200Medicaid
NJ053036Medicare ID - Type Unspecified