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General NPI Number Information
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NPI Number | 1356082754
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Entity Type | Organization
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Legal Business Name | SUMMIT NEUROTHERAPY
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Dates
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Enumeration Date | 04/07/2022
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 11 COMMERCE DR
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City | CRANFORD
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State | NJ
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Zip | 07016-3501
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Country | US
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Telephone | 908-209-0684
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Fax |
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Provider Business Mailing Address
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Address Line | 45 NOMAHEGAN DR
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City | WESTFIELD
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State | NJ
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Zip | 07090-1007
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Country | US
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Telephone | 908-209-6842
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JAMES MESSINA
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Credential | PH.D.
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Telephone | 908-209-6842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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