Provider Demographics
NPI:1821202748
Name:GREATER NEW JERSEY NEUROMONITORING LLC
Entity Type:Organization
Organization Name:GREATER NEW JERSEY NEUROMONITORING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:EMANUEL
Authorized Official - Last Name:GRUPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-322-8105
Mailing Address - Street 1:5 VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4013
Mailing Address - Country:US
Mailing Address - Phone:410-322-8105
Mailing Address - Fax:410-879-3015
Practice Address - Street 1:5 VILLAGE CT
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4013
Practice Address - Country:US
Practice Address - Phone:410-322-8105
Practice Address - Fax:410-879-3015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty