Healthcare Provider Details

I. General information

NPI: 1225600398
Provider Name (Legal Business Name): HUNTERDON NEUROLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 STATE ROUTE 31 N STE 2
ANNANDALE NJ
08801-3127
US

IV. Provider business mailing address

6 MORNINGSIDE CT
FLEMINGTON NJ
08822-5950
US

V. Phone/Fax

Practice location:
  • Phone: 908-894-7222
  • Fax: 908-894-7128
Mailing address:
  • Phone: 908-240-2483
  • Fax: 908-894-7128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MANISH B VIRADIA
Title or Position: OWNER
Credential: MD
Phone: 908-894-7222