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General NPI Number Information
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NPI Number | 1346294170
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Entity Type | Organization
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Legal Business Name | JERSEY SHORE NEUROLOGY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1900 CORLIES AVE
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City | NEPTUNE
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State | NJ
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Zip | 07753-4800
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Country | US
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Telephone | 732-775-2400
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Fax | 732-775-5673
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Provider Business Mailing Address
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Address Line | 1900 CORLIES AVE
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City | NEPTUNE
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State | NJ
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Zip | 07753-4800
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Country | US
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Telephone | 732-775-2400
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Fax | 732-775-5673
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LYNDA L. TEBBS
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Credential |
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Telephone | 732-775-2400
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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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