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General NPI Number Information
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NPI Number | 1942876586
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Entity Type | Organization
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Legal Business Name | NEUROPSYCHOLOGY DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 220 LENOX AVE STE 201
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City | WESTFIELD
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State | NJ
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Zip | 07090-5119
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Country | US
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Telephone | 908-868-8022
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Fax |
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Provider Business Mailing Address
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Address Line | 450 KIMBALL TURN
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City | WESTFIELD
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State | NJ
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Zip | 07090-2325
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Country | US
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Telephone | 908-868-8022
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Fax |
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Authorized Official
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Title or Position | CLINICAL NEUROPSYCHOLOGIST
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Name | SARA MICHAUD
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Credential |
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Telephone | 908-913-0694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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