Provider Demographics
NPI:1538105457
Name:NEUROLOGY CONSULTANTS
Entity Type:Organization
Organization Name:NEUROLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-795-2000
Mailing Address - Street 1:1415 E ROUTE 70
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034
Mailing Address - Country:US
Mailing Address - Phone:856-795-2000
Mailing Address - Fax:856-795-3625
Practice Address - Street 1:1415 E ROUTE 70
Practice Address - Street 2:SUITE 204
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034
Practice Address - Country:US
Practice Address - Phone:856-795-2000
Practice Address - Fax:856-795-3625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3413101Medicaid
NJCB0073OtherMEDICARE ID
NJ3413101Medicaid