Provider Demographics
NPI:1437216371
Name:NEUROLOGICAL ASSOCIATES OF EAST BERGEN, PA
Entity Type:Organization
Organization Name:NEUROLOGICAL ASSOCIATES OF EAST BERGEN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-263-0101
Mailing Address - Street 1:261 OLD HOOK RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3102
Mailing Address - Country:US
Mailing Address - Phone:201-263-0101
Mailing Address - Fax:201-666-2137
Practice Address - Street 1:261 OLD HOOK RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3102
Practice Address - Country:US
Practice Address - Phone:201-263-0101
Practice Address - Fax:201-666-2137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ576769Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER