Healthcare Provider Details

I. General information

NPI: 1851274641
Provider Name (Legal Business Name): NEURO PRO WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 NJ 10 UNIT 4
EAST HANOVER NJ
07936
US

IV. Provider business mailing address

35 HUDSON ST APT 2407W
JERSEY CITY NJ
07302-6621
US

V. Phone/Fax

Practice location:
  • Phone: 914-297-8712
  • Fax:
Mailing address:
  • Phone: 484-894-3142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDRA E MCGIVERN
Title or Position: OWNER
Credential: PT, DPT, NCS
Phone: 914-297-8712