Provider Demographics
NPI:1487011813
Name:THE NEUROPSYCHOLOGY CENTER, LLC
Entity Type:Organization
Organization Name:THE NEUROPSYCHOLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-783-7930
Mailing Address - Street 1:325 E JIMMIE LEEDS RD
Mailing Address - Street 2:#119
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28 S NEW YORK RD
Practice Address - Street 2:SUITE B-5
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9695
Practice Address - Country:US
Practice Address - Phone:800-783-7930
Practice Address - Fax:800-783-7930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty