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General NPI Number Information
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NPI Number | 1013998830
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Entity Type | Organization
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Legal Business Name | EPILEPSY & NEUROPHYSIOLOGY MEDICAL CONSULTANTS PA
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 20 PROSPECT AVE SUITE 800
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City | HACKENSACK
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State | NJ
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Zip | 07601-1997
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Country | US
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Telephone | 201-996-3205
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Fax | 201-343-6689
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Provider Business Mailing Address
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Address Line | 333 WESTCHESTER AVE STE E104
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City | WHITE PLAINS
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State | NY
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Zip | 10604-2930
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Country | US
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Telephone | 914-428-3651
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Fax | 914-428-2948
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARCELO E LANCMAN
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Credential | MD
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Telephone | 914-428-3651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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