Provider Demographics
NPI:1891833646
Name:NEUROLOGY ST FRANCIS MEDICAL CENTER
Entity Type:Organization
Organization Name:NEUROLOGY ST FRANCIS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-599-5792
Mailing Address - Street 1:601 HAMILTON AVE
Mailing Address - Street 2:ST FRANCIS MEDICAL CENTER
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08629-1915
Mailing Address - Country:US
Mailing Address - Phone:609-599-5792
Mailing Address - Fax:609-599-6275
Practice Address - Street 1:601 HAMILTON AVE
Practice Address - Street 2:NEUROLOGY ST FRANCIS MEDICAL CENTER
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08629-1915
Practice Address - Country:US
Practice Address - Phone:609-599-5792
Practice Address - Fax:609-599-6275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0001538Medicaid
NJ0115331000OtherAMERIHEALTH
CH1667OtherRR MEDICARE
PA528973OtherBCBS PA
CH1667OtherRR MEDICARE