Provider Demographics
NPI:1689370488
Name:NEUROKIN LLC
Entity Type:Organization
Organization Name:NEUROKIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:908-215-2331
Mailing Address - Street 1:560 SPRINGFIELD AVE STE I
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1024
Mailing Address - Country:US
Mailing Address - Phone:908-215-2331
Mailing Address - Fax:
Practice Address - Street 1:560 SPRINGFIELD AVE STE I
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1024
Practice Address - Country:US
Practice Address - Phone:908-215-2331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty