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NPI Code Detail

MEDICARE: ON DEMAND NEUROLOGY OF NJ, P.A.

MEDICARE: ON DEMAND NEUROLOGY OF NJ, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician

General Provider Information

NPI Number : 1114618717
Entity Type Code : Organization
Provider Name (Legal Business Name) : ON DEMAND NEUROLOGY OF NJ, P.A.
Provider Business Mailing Address
First Line : 205 E 42ND ST STE 1947
Second Line :
City : NEW YORK
State : NY
Zip : 10017-5773
Country : US
Telephone Number : 313-887-0960
Fax Number : 212-214-0885
Provider Business Practice Location Address
First Line : 221 RIVER ST STE 9
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-5990
Country : US
Telephone Number : 313-887-0960
Fax Number : 212-214-0885
Authorized Official
Title or Position : HEAD OF PAYOR RELATIONS
Name : JED REAUX
Credential :
Telephone Number : 337-772-9738
Provider Enumeration Date : 05/16/2023
Last Update Date : 01/16/2026

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Directions to “ON DEMAND NEUROLOGY OF NJ, P.A. ” Practice Location

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