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General NPI Number Information
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NPI Number | 1013350768
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Entity Type | Organization
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Legal Business Name | NEURO-PSYCHOLOGY PRACTICE PLLC
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Dates
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Enumeration Date | 04/12/2013
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 5030 BROADWAY SUITE 809
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City | NEW YORK
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State | NY
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Zip | 10034-1609
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Country | US
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Telephone | 800-240-1038
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Fax |
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Provider Business Mailing Address
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Address Line | 417 HIDDEN VALLEY DR
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City | EDISON
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State | NJ
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Zip | 08820-3491
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Country | US
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Telephone | 469-693-2757
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Fax | 888-770-4153
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MS. BARBARA COUVADELLI
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Credential | PHD
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Telephone | 800-240-1038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 019337-1
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License Number State | NY
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