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General NPI Number Information
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NPI Number | 1942718929
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Entity Type | Organization
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Legal Business Name | BEACON NEURODIAGNOSTIC ASSOCIATES LLC.
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 106 E MOORE ST
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-2026
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Country | US
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Telephone | 347-996-4398
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Fax |
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Provider Business Mailing Address
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Address Line | 106 E MOORE ST
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-2026
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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 | PRESIDENT/CEO
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Name | UZMA KAZMI
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Credential |
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Telephone | 917-923-9949
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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 |
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