Provider Demographics
NPI:1841573375
Name:NEUROCOGNITIVE INSTITUTE
Entity Type:Organization
Organization Name:NEUROCOGNITIVE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAMONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-601-0100
Mailing Address - Street 1:111 HOWARD BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-1315
Mailing Address - Country:US
Mailing Address - Phone:973-601-0100
Mailing Address - Fax:973-440-1656
Practice Address - Street 1:111 HOWARD BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:MT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856-1315
Practice Address - Country:US
Practice Address - Phone:973-601-0100
Practice Address - Fax:973-440-1656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty