| Neurological Institute Of Northern New Jersey | |
|
340 E Northfield Rd Ste 1b Livingston NJ 07039-4892 | |
| (973) 974-9946 | |
| (973) 500-4411 |
| Full Name | Neurological Institute Of Northern New Jersey |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 340 E Northfield Rd Ste 1b, Livingston, New Jersey |
| Authorized Official Name and Position | Guha Venkatraman (PRESIDENT) |
| Authorized Official Contact | 9732558920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurological Institute Of Northern New Jersey 340 E Northfield Rd Ste 1b Livingston NJ 07039-4892 Ph: (973) 974-9946 | Neurological Institute Of Northern New Jersey 340 E Northfield Rd Ste 1b Livingston NJ 07039-4892 Ph: (973) 974-9946 |
| NPI Number | 1487059978 |
|---|---|
| Provider Enumeration Date | 10/27/2014 |
| Last Update Date | 04/17/2023 |
| Certification Date | 04/17/2023 |
| Medicare PECOS PAC ID | 3173836020 |
|---|---|
| Medicare Enrollment ID | O20150721001466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487059978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 272570-1 (New York) | Primary |
| Provider Name | Guha K Venkatraman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356517593 PECOS PAC ID: 3476721887 Enrollment ID: I20110729000042 |
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