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General NPI Number Information
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NPI Number | 1831310176
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Entity Type | Organization
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Legal Business Name | MEMORIAL ELECTRODIAGNOSTIC ASSOCIATES
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 100 MADISON AVE
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6136
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Country | US
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Telephone | 908-813-3100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 207 121 MAPLE AVENUE
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-0207
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PETER MCCABE
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Credential |
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Telephone | 908-813-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NJ
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