Provider Demographics
NPI:1275268351
Name:ATLANTIC NEUROCARE LLC
Entity Type:Organization
Organization Name:ATLANTIC NEUROCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-337-3563
Mailing Address - Street 1:25B HANOVER RD STE 150
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1410
Mailing Address - Country:US
Mailing Address - Phone:973-221-2139
Mailing Address - Fax:
Practice Address - Street 1:25B HANOVER RD STE 150
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1410
Practice Address - Country:US
Practice Address - Phone:973-221-2139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty