Healthcare Provider Details

I. General information

NPI: 1992768220
Provider Name (Legal Business Name): NEUROLOGY SPECIALISTS OF MONMOUTH COUNTY NJ PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 MONMOUTH RD
WEST LONG BRANCH NJ
07764
US

IV. Provider business mailing address

107 MONMOUTH RD
WEST LONG BRANCH NJ
07764
US

V. Phone/Fax

Practice location:
  • Phone: 732-935-1850
  • Fax: 732-544-0494
Mailing address:
  • Phone: 732-935-1850
  • Fax: 732-544-0494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSHUA MENDELSON
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 732-935-1850