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General NPI Number Information
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NPI Number | 1497466858
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Entity Type | Organization
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Legal Business Name | EDISON NEUROLOGY LLC
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Dates
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Enumeration Date | 12/07/2022
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | CAREWELL HEALTH MEDICAL CENTER 300 CENTRAL AVENUE
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City | EAST ORANGE
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State | NJ
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Zip | 07018
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Country | US
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Telephone | 973-672-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 17 ANNA LN
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City | EDISON
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State | NJ
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Zip | 08820-1503
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Country | US
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Telephone | 908-672-0403
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Fax | 908-756-6879
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Authorized Official
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Title or Position | OWNER
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Name | HASMUKH SUTARIA
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Credential | MD
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Telephone | 908-672-0403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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