Healthcare Provider Details
I. General information
NPI: 1255247896
Provider Name (Legal Business Name): THE JEYAMOHAN INSTITUTE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
414 EAGLE ROCK AVE STE 305
WEST ORANGE NJ
07052-4224
US
IV. Provider business mailing address
414 EAGLE ROCK AVE STE 305
WEST ORANGE NJ
07052-4224
US
V. Phone/Fax
- Phone: 609-575-3698
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SHIVEINDRA
JEYAMOHAN
Title or Position: OWNER
Credential: MD
Phone: 609-575-3698