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General NPI Number Information
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NPI Number | 1578598090
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Entity Type | Organization
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Legal Business Name | NJ IDTF, LLC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 03/30/2025
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Provider Practice Location Address
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Address Line | 14 SNOWHILL ST
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City | SPOTSWOOD
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State | NJ
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Zip | 08884-1358
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Country | US
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Telephone | 732-690-5846
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Fax | 732-518-5220
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Provider Business Mailing Address
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Address Line | 14 SNOWHILL ST
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City | SPOTSWOOD
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State | NJ
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Zip | 08884-1358
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Country | US
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Telephone | 732-690-2875
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Fax | 732-518-5220
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WALTER HUSAR
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Credential | M.D.
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Telephone | 732-690-2875
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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 | 25MA05323800
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License Number State | NJ
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