Provider Demographics
NPI:1801825773
Name:NEUROLOGY AND NEUROPHYSIOLOGY ASSOCIATES OF NJ, P.C.
Entity Type:Organization
Organization Name:NEUROLOGY AND NEUROPHYSIOLOGY ASSOCIATES OF NJ, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:MANON-ESPAILLAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-574-0075
Mailing Address - Street 1:1015 CHESTNUT ST
Mailing Address - Street 2:SUITE 810
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4316
Mailing Address - Country:US
Mailing Address - Phone:215-574-0075
Mailing Address - Fax:215-574-0861
Practice Address - Street 1:151 FRIES MILL RD
Practice Address - Street 2:SUITE 506
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2016
Practice Address - Country:US
Practice Address - Phone:856-228-0006
Practice Address - Fax:856-228-7080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ747980Medicare PIN