| Complete Neurological Care Of Nj Pc | |
|
124 Gregory Ave Suite 203 Passaic NJ 07055-4856 | |
| (212) 349-2787 | |
| Not Available |
| Full Name | Complete Neurological Care Of Nj Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 124 Gregory Ave, Passaic, New Jersey |
| Authorized Official Name and Position | Ellen I Edgar (OWNER) |
| Authorized Official Contact | 2123492787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Neurological Care Of Nj Pc 308 Myers Ave Hasbrouck Heights NJ 07604-2236 Ph: () - | Complete Neurological Care Of Nj Pc 124 Gregory Ave Suite 203 Passaic NJ 07055-4856 Ph: (212) 349-2787 |
| NPI Number | 1134668981 |
|---|---|
| Provider Enumeration Date | 02/13/2017 |
| Last Update Date | 02/13/2017 |
| Medicare PECOS PAC ID | 7719254887 |
|---|---|
| Medicare Enrollment ID | O20170519000875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134668981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | 25MA09993200 (New Jersey) | Primary |
| Provider Name | Gautami K Rao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083795264 PECOS PAC ID: 5890884084 Enrollment ID: I20110601000482 |
| Provider Name | Kishan A Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346473071 PECOS PAC ID: 6608003157 Enrollment ID: I20170524001279 |
| Provider Name | Ellen I Edgar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326343625 PECOS PAC ID: 4486838885 Enrollment ID: I20170525001966 |
| Provider Name | Bijal Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063970432 PECOS PAC ID: 7214279892 Enrollment ID: I20190501000669 |
| Provider Name | Kimberly J Perdomo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861068827 PECOS PAC ID: 2365846615 Enrollment ID: I20210809001033 |
| Provider Name | Samuel Apeatu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013939545 PECOS PAC ID: 5991886491 Enrollment ID: I20220830001899 |
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