| New Jersey Brain Care | |
|
1 Springfield Ave Ste 2c Summit NJ 07901-4055 | |
| (908) 393-1533 | |
| (908) 393-1534 |
| Full Name | New Jersey Brain Care |
|---|---|
| Speciality | Psychologist |
| Location | 1 Springfield Ave Ste 2c, Summit, New Jersey |
| Authorized Official Name and Position | Lynette Mckeon (NEUROPSYCHOLOGIST / BUSINESS OWNER) |
| Authorized Official Contact | 9083931533 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Jersey Brain Care 1 Springfield Ave Ste 2c Summit NJ 07901-4055 Ph: (908) 393-1533 | New Jersey Brain Care 1 Springfield Ave Ste 2c Summit NJ 07901-4055 Ph: (908) 393-1533 |
| NPI Number | 1710104864 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Medicare PECOS PAC ID | 2466559943 |
|---|---|
| Medicare Enrollment ID | O20070517000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710104864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 4059 (New Jersey) | Secondary |
| 103TC0700X | Psychologist - Clinical | 4059 (New Jersey) | Primary |
| Provider Name | Lisa Ann Slapa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861531212 PECOS PAC ID: 5193767721 Enrollment ID: I20050524001158 |
| Provider Name | Lynette L Mckeon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477695674 PECOS PAC ID: 1456457860 Enrollment ID: I20070501000648 |
| Provider Name | Albert Jason Sultan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902439987 PECOS PAC ID: 8729405733 Enrollment ID: I20200903003400 |
| Provider Name | Samantha Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942946249 PECOS PAC ID: 1850779836 Enrollment ID: I20220602002995 |
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