| Shore Tms Llc | |
|
615 Hope Rd Ste 2 Eatontown NJ 07724-1273 | |
| (732) 389-4482 | |
| Not Available |
| Full Name | Shore Tms Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 615 Hope Rd Ste 2, Eatontown, New Jersey |
| Authorized Official Name and Position | David Wolff (OWNER) |
| Authorized Official Contact | 7323894482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Tms Llc 615 Hope Road Building 2 Eatontown NJ 07724-0772 Ph: (732) 389-4482 | Shore Tms Llc 615 Hope Rd Ste 2 Eatontown NJ 07724-1273 Ph: (732) 389-4482 |
| NPI Number | 1073010237 |
|---|---|
| Provider Enumeration Date | 04/12/2018 |
| Last Update Date | 04/12/2018 |
| Medicare PECOS PAC ID | 3173871670 |
|---|---|
| Medicare Enrollment ID | O20180731001468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073010237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 25MA0554100 (New Jersey) | Primary |
| Provider Name | David E Wolff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699971200 PECOS PAC ID: 4486621224 Enrollment ID: I20040913000371 |
| Provider Name | Adeoluwa Modupe Adeyemo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285209536 PECOS PAC ID: 5395044580 Enrollment ID: I20210820000026 |
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