Provider Demographics
NPI:1770779928
Name:CENTRAL JERSEY NEUROLOGY ASSOCIATES, P.A.
Entity type:Organization
Organization Name:CENTRAL JERSEY NEUROLOGY ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-764-7343
Mailing Address - Street 1:501 IRON BRIDGE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5305
Mailing Address - Country:US
Mailing Address - Phone:732-462-7030
Mailing Address - Fax:732-308-3562
Practice Address - Street 1:501 IRON BRIDGE RD STE 3
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5305
Practice Address - Country:US
Practice Address - Phone:732-462-7030
Practice Address - Fax:732-308-3562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3390900Medicaid
NJ526903OtherGROUP'S MEDICARE ID NUMBE