Healthcare Provider Details

I. General information

NPI: 1528312923
Provider Name (Legal Business Name): NORTH JERSEY NEUROSURGICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 DAYTON ST
RIDGEWOOD NJ
07450-4407
US

IV. Provider business mailing address

225 DAYTON ST
RIDGEWOOD NJ
07450-4407
US

V. Phone/Fax

Practice location:
  • Phone: 201-612-0020
  • Fax: 201-612-0333
Mailing address:
  • Phone: 201-612-0020
  • Fax: 201-612-0333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CARI PERRICELLI
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 201-612-0020