Provider Demographics
NPI:1922290352
Name:NEUROPSYCHOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:DORFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-227-5992
Mailing Address - Street 1:51A JAMES ST APT 6
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2973
Mailing Address - Country:US
Mailing Address - Phone:973-746-1526
Mailing Address - Fax:
Practice Address - Street 1:1140 BLOOMFIELD AVE STE 232
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7132
Practice Address - Country:US
Practice Address - Phone:973-227-5992
Practice Address - Fax:973-227-5997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100419200103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty