Provider Demographics
NPI:1437313368
Name:BROMLEY NEUROLOGY, PC
Entity Type:Organization
Organization Name:BROMLEY NEUROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-546-2300
Mailing Address - Street 1:739 S WHITE HORSE PIKE
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1659
Mailing Address - Country:US
Mailing Address - Phone:856-546-2300
Mailing Address - Fax:856-546-2301
Practice Address - Street 1:739 S WHITE HORSE PIKE
Practice Address - Street 2:SUITE ONE
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1659
Practice Address - Country:US
Practice Address - Phone:856-546-2300
Practice Address - Fax:856-546-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA075642002084N0400X
NJ25MP00144400363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2279321000OtherAMERIHEALTH
NJP3118807OtherOXFORD
NJ3394542OtherAETNA
NJ076891Medicare PIN