Provider Demographics
NPI:1528407731
Name:SENSORYPG
Entity Type:Organization
Organization Name:SENSORYPG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:732-972-8900
Mailing Address - Street 1:704 GINESI DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1249
Mailing Address - Country:US
Mailing Address - Phone:732-972-8900
Mailing Address - Fax:732-972-8909
Practice Address - Street 1:704 GINESI DR
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1249
Practice Address - Country:US
Practice Address - Phone:732-972-8900
Practice Address - Fax:732-972-8909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00587900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1134364862OtherBLUECROSS