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General NPI Number Information
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NPI Number | 1275355596
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Entity Type | Organization
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Legal Business Name | SYNAPSE WELLNESS
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 629 AMBOY AVE FL 3
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City | EDISON
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State | NJ
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Zip | 08837-3579
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Country | US
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Telephone | 848-219-1602
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Fax |
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Provider Business Mailing Address
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Address Line | 32 KOSTER BLVD APT 1B
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City | EDISON
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State | NJ
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Zip | 08837-4272
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Country | US
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Telephone | 848-219-1602
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | IBRAHIM ALSHERIEF
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Credential | DO
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Telephone | 848-219-1602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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