| Suburban Neurology Pc | |
|
111 East Northfield Road Livingston NJ 07039 | |
| (973) 992-9819 | |
| (973) 535-9819 |
| Full Name | Suburban Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 111 East Northfield Road, Livingston, New Jersey |
| Authorized Official Name and Position | Yanchun Zhang (PRESIDENT) |
| Authorized Official Contact | 9739929819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suburban Neurology Pc 111 East Northfield Road Livingston NJ 07039 Ph: (973) 992-9819 | Suburban Neurology Pc 111 East Northfield Road Livingston NJ 07039 Ph: (973) 992-9819 |
| NPI Number | 1265593065 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6305017187 |
|---|---|
| Medicare Enrollment ID | O20110928000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265593065 | NPI | - | NPPES |
| 7204001 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | MA065380 (New Jersey) | Primary |
| Provider Name | Yanchun Zhang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841363520 PECOS PAC ID: 8921279704 Enrollment ID: I20110928000157 |
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