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General NPI Number Information
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NPI Number | 1851794903
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Entity Type | Organization
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Legal Business Name | GNI NEUROSERVICES LLC
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Dates
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Enumeration Date | 10/03/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3100 PRINCETON PIKE BLDG 3 SUITE D
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2300
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Country | US
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Telephone | 844-464-6387
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Fax | 215-239-3037
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER BLVD STE 232
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City | CHESTER
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State | PA
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Zip | 19013-3902
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Country | US
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Telephone | 844-464-6387
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Fax | 215-239-3037
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Authorized Official
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Title or Position | VICE PRESIDENT, ADMINISTRATION
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Name | MR. DONALD J. DAMICO
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Credential |
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Telephone | 215-962-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State | PA
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