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General NPI Number Information
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NPI Number | 1962682989
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR NEUROLOGICAL AND NEURODEVELOPMENTAL HEALTH, LLC
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 2050 VOORHEES TOWN CENTER
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City | VOORHEES
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State | NJ
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Zip | 08043-3806
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Country | US
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Telephone | 856-346-0005
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Fax |
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Provider Business Mailing Address
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Address Line | 2050 VOORHEES TOWN CENTER
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City | VOORHEES
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State | NJ
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Zip | 08043-3512
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Country | US
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Telephone | 856-346-0005
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. DANIEL CLEMONS
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Credential |
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Telephone | 856-346-0005
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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 |
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License Number State |
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