Provider Demographics
NPI:1841510583
Name:CAPITAL REGIONAL NEUROLOGY OF NJ PC
Entity type:Organization
Organization Name:CAPITAL REGIONAL NEUROLOGY OF NJ PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WARE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:609-510-3442
Mailing Address - Street 1:28 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-2054
Mailing Address - Country:US
Mailing Address - Phone:908-407-6176
Mailing Address - Fax:
Practice Address - Street 1:28 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-2054
Practice Address - Country:US
Practice Address - Phone:908-407-6176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5550700Medicaid
NJ8551102Medicaid
NJ047696DAPMedicare PIN
NJF57476Medicare UPIN
NJ746030DAPMedicare PIN
NJ8551102Medicaid