Provider Demographics
NPI:1568841195
Name:NORTH NEW JERSEY NEUROLOGICAL SPECIALISTS, PA
Entity Type:Organization
Organization Name:NORTH NEW JERSEY NEUROLOGICAL SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-428-3651
Mailing Address - Street 1:400 FRANK W. BURR BOULEVARD
Mailing Address - Street 2:GLENPOINTECENTRE ATRIUM SUITE 55
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:914-428-3651
Mailing Address - Fax:914-428-2948
Practice Address - Street 1:400 FRANK W. BURR BOULEVARD
Practice Address - Street 2:GLENPOINTECENTRE ATRIUM SUITE 55
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:914-428-3651
Practice Address - Fax:914-428-2948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty