Healthcare Provider Details

I. General information

NPI: 1407788169
Provider Name (Legal Business Name): ELITE NEURO DIAGNOSTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 HANOVER PL
WAYNE NJ
07470-3613
US

IV. Provider business mailing address

37 HANOVER PL
WAYNE NJ
07470-3613
US

V. Phone/Fax

Practice location:
  • Phone: 201-707-4799
  • Fax:
Mailing address:
  • Phone: 201-707-4799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273100000X
TaxonomyEpilepsy Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: ANDREW ZAITOUN
Title or Position: OWNER
Credential: TECHNOLOGIST
Phone: 201-707-4799