Provider Demographics
NPI:1710762786
Name:SYNAPSE BRAIN & SPINE CENTER LLC
Entity Type:Organization
Organization Name:SYNAPSE BRAIN & SPINE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WATERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-319-1446
Mailing Address - Street 1:19413 JINGLE SHELL WAY UNIT 2
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-6307
Mailing Address - Country:US
Mailing Address - Phone:908-319-1446
Mailing Address - Fax:
Practice Address - Street 1:19413 JINGLE SHELL WAY UNIT 2
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-6307
Practice Address - Country:US
Practice Address - Phone:908-319-1446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center