| Neurology Consultants Of South Jersey, Llc | |
|
76 W Jimmie Leeds Rd Suite 503 Galloway NJ 08205-9411 | |
| (609) 748-7820 | |
| (609) 748-7825 |
| Full Name | Neurology Consultants Of South Jersey, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 76 W Jimmie Leeds Rd, Galloway, New Jersey |
| Authorized Official Name and Position | Iman Shawki Youssef (MEMBER) |
| Authorized Official Contact | 6096531024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology Consultants Of South Jersey, Llc 24 Marshall Dr Egg Harbor Township NJ 08234-6002 Ph: (609) 653-1024 | Neurology Consultants Of South Jersey, Llc 76 W Jimmie Leeds Rd Suite 503 Galloway NJ 08205-9411 Ph: (609) 748-7820 |
| NPI Number | 1780722314 |
|---|---|
| Provider Enumeration Date | 02/04/2007 |
| Last Update Date | 08/10/2007 |
| Medicare PECOS PAC ID | 0547358228 |
|---|---|
| Medicare Enrollment ID | O20071113000641 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780722314 | NPI | - | NPPES |
| 8649308 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | 25MA07153100 (New Jersey) | Primary |
| Provider Name | Iman S Youssef |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386679942 PECOS PAC ID: 2961394390 Enrollment ID: I20040329001137 |
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