Healthcare Provider Details

I. General information

NPI: 1841597762
Provider Name (Legal Business Name): COMPREHENSIVE NEUROLOGY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 FRIES MILL RD SUITE N-3
TURNERSVILLE NJ
08012-2015
US

IV. Provider business mailing address

PO BOX 8887
TURNERSVILLE NJ
08012-8887
US

V. Phone/Fax

Practice location:
  • Phone: 856-875-3565
  • Fax: 856-875-3591
Mailing address:
  • Phone: 856-875-3565
  • Fax: 856-375-3591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMA074102
License Number StateNJ

VIII. Authorized Official

Name: DAHLIA J IRBY
Title or Position: OWNER
Credential: M.D.
Phone: 856-875-3565