Provider Demographics
NPI:1700108164
Name:NEUROCOGNITIVE ASSOCIATES, PC
Entity Type:Organization
Organization Name:NEUROCOGNITIVE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:STEINHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:201-696-3838
Mailing Address - Street 1:221 W GRAND AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1729
Mailing Address - Country:US
Mailing Address - Phone:201-696-3838
Mailing Address - Fax:845-503-2214
Practice Address - Street 1:221 W GRAND AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1729
Practice Address - Country:US
Practice Address - Phone:201-696-3838
Practice Address - Fax:845-503-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ03883103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty