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General NPI Number Information
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NPI Number | 1447554001
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Entity Type | Organization
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Legal Business Name | EPILEPSY AND NEUROLOGY GROUP, LLC
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 901 W MAIN ST SUITE 260, CN5050
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City | FREEHOLD
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State | NJ
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Zip | 07728-2537
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Country | US
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Telephone | 732-414-8585
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Fax | 732-875-0509
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Provider Business Mailing Address
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Address Line | 9 DELAWARE DR
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3256
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Country | US
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Telephone | 732-414-8585
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Fax | 732-875-0509
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MEGDAD ZAATREH
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Credential | M.D
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Telephone | 732-407-6555
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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 | 25MA08078600
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License Number State | NJ
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