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General NPI Number Information
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NPI Number | 1215225529
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Entity Type | Organization
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Legal Business Name | AFFILIATED NEUROLOGY A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 23 KILMER DR BLDG 1 SUITE E
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1563
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Country | US
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Telephone | 732-617-0808
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Fax |
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Provider Business Mailing Address
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Address Line | 23 KILMER DR BLDG 1 SUITE E
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1563
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Country | US
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Telephone | 732-617-0808
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICK GAINEY
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Credential | M.D.
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Telephone | 732-617-0808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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