| Rutgers Health-rwj Neurology Group | |
|
125 Paterson St Suite 6100 New Brunswick NJ 08901-1962 | |
| (732) 235-7733 | |
| (732) 235-7041 |
| Full Name | Rutgers Health-rwj Neurology Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 125 Paterson St, New Brunswick, New Jersey |
| Authorized Official Name and Position | Brenda Lawrence (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Contact | 7322356070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rutgers Health-rwj Neurology Group 66 W Gilbert St Tinton Falls NJ 07701-4947 Ph: (732) 212-0051 | Rutgers Health-rwj Neurology Group 125 Paterson St Suite 6100 New Brunswick NJ 08901-1962 Ph: (732) 235-7733 |
| NPI Number | 1366487183 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 01/19/2021 |
| Certification Date | 01/19/2021 |
| Medicare PECOS PAC ID | 2860485141 |
|---|---|
| Medicare Enrollment ID | O20040405000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366487183 | NPI | - | NPPES |
| 3470105 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Michael Moussouttas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912907197 PECOS PAC ID: 4284623885 Enrollment ID: I20040716000911 |
| Provider Name | Michelle Moccio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528133709 PECOS PAC ID: 7012970544 Enrollment ID: I20041105000731 |
| Provider Name | Konstantin Balashov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083789556 PECOS PAC ID: 7911940051 Enrollment ID: I20050609000014 |
| Provider Name | Yaritza M Rosario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962424291 PECOS PAC ID: 3577665496 Enrollment ID: I20070223000477 |
| Provider Name | Brian L Gerhardstein |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790982064 PECOS PAC ID: 4981799384 Enrollment ID: I20071001000181 |
| Provider Name | Ugo Paolucci |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265658793 PECOS PAC ID: 9032287040 Enrollment ID: I20081003000590 |
| Provider Name | Stephen Wong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942293881 PECOS PAC ID: 7719922707 Enrollment ID: I20090728000365 |
| Provider Name | Deborah Caputo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013105634 PECOS PAC ID: 1355476201 Enrollment ID: I20100317000106 |
| Provider Name | Suhayl S Dhib-jalbut |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518032093 PECOS PAC ID: 6406048370 Enrollment ID: I20101011000518 |
| Provider Name | Frederick E Lepore |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710052204 PECOS PAC ID: 5597957480 Enrollment ID: I20101011000652 |
| Provider Name | Lawrence I Golbe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215002795 PECOS PAC ID: 7719179530 Enrollment ID: I20101011001153 |
| Provider Name | Vikram V Bhise |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700047594 PECOS PAC ID: 7012106123 Enrollment ID: I20110105000420 |
| Provider Name | M. Maral Mouradian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750457305 PECOS PAC ID: 4385823160 Enrollment ID: I20110126000012 |
| Provider Name | Jacob I Sage |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912072109 PECOS PAC ID: 7315126067 Enrollment ID: I20110126001001 |
| Provider Name | Ram Mani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801003199 PECOS PAC ID: 6709913775 Enrollment ID: I20110705000130 |
| Provider Name | Shan Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184940017 PECOS PAC ID: 5890964803 Enrollment ID: I20110809000355 |
| Provider Name | Aphrodite M Zimmerman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932303583 PECOS PAC ID: 2365699899 Enrollment ID: I20120905000665 |
| Provider Name | Megan M Leitch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457593022 PECOS PAC ID: 1052554391 Enrollment ID: I20130905000420 |
| Provider Name | Igor Rybinnik |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710146386 PECOS PAC ID: 4183894983 Enrollment ID: I20130925000021 |
| Provider Name | Deviyani D Mehta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891927158 PECOS PAC ID: 3476746249 Enrollment ID: I20140311000515 |
| Provider Name | Asha Cilly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235506205 PECOS PAC ID: 6608185673 Enrollment ID: I20151014002845 |
| Provider Name | Mini Jomartin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457720880 PECOS PAC ID: 7911217146 Enrollment ID: I20151030000596 |
| Provider Name | Rehan Aziz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457391310 PECOS PAC ID: 3072515618 Enrollment ID: I20160506000452 |
| Provider Name | Matthew Tal Scharf |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841519527 PECOS PAC ID: 8527283860 Enrollment ID: I20160902000247 |
| Provider Name | Kiwon Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710908322 PECOS PAC ID: 2163490970 Enrollment ID: I20170726000499 |
| Provider Name | Shelly Rishty |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053678672 PECOS PAC ID: 7810260783 Enrollment ID: I20170829002965 |
| Provider Name | Brad K Kamitaki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831455005 PECOS PAC ID: 4385930312 Enrollment ID: I20180612000366 |
| Provider Name | Ram C Gowda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710240254 PECOS PAC ID: 5092001362 Enrollment ID: I20180625001012 |
| Provider Name | Pengfei Zhang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730455734 PECOS PAC ID: 6406138619 Enrollment ID: I20180705000882 |
| Provider Name | Roger C Cheng |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063788404 PECOS PAC ID: 9931492816 Enrollment ID: I20180827002098 |
| Provider Name | Jennifer Yu Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104124643 PECOS PAC ID: 4385994292 Enrollment ID: I20180913001355 |
| Provider Name | Priyank Khandelwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225347727 PECOS PAC ID: 2668762881 Enrollment ID: I20180921002325 |
| Provider Name | Emad Nourollah-zadeh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164734687 PECOS PAC ID: 2365763976 Enrollment ID: I20190711003447 |
| Provider Name | Yeva Mui Fernandez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629332663 PECOS PAC ID: 6709154941 Enrollment ID: I20190916000007 |
| Provider Name | Gian Dev Pal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629239371 PECOS PAC ID: 1951541028 Enrollment ID: I20200604001156 |
| Provider Name | Raymond Vincent Mirasol |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659758035 PECOS PAC ID: 1052605425 Enrollment ID: I20201019003017 |
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