Provider Demographics
NPI:1619421625
Name:PATHWAYS NEUROPSYCHOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:PATHWAYS NEUROPSYCHOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-597-5521
Mailing Address - Street 1:1301 ROUTE 72 W
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2483
Mailing Address - Country:US
Mailing Address - Phone:609-597-5521
Mailing Address - Fax:609-597-5528
Practice Address - Street 1:1301 ROUTE 72 W
Practice Address - Street 2:SUITE 250
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2483
Practice Address - Country:US
Practice Address - Phone:609-597-5521
Practice Address - Fax:609-597-5528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty