| Bergen Passaic Pediatric Neurology | |
|
66 Glen Ave Glen Rock NJ 07452-2132 | |
| (201) 796-9500 | |
| (201) 796-9509 |
| Full Name | Bergen Passaic Pediatric Neurology |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology |
| Location | 66 Glen Ave, Glen Rock, New Jersey |
| Authorized Official Name and Position | Judy Woo (MEMBER) |
| Authorized Official Contact | 2017969500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Passaic Pediatric Neurology Po Box 919 Glen Rock NJ 07452-0919 Ph: (201) 796-9500 | Bergen Passaic Pediatric Neurology 66 Glen Ave Glen Rock NJ 07452-2132 Ph: (201) 796-9500 |
| NPI Number | 1417009077 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 01/25/2023 |
| Certification Date | 01/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417009077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | 25MA05494400 (New Jersey) | Primary |
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