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NPI Code Detail

MEDICARE: THE CENTER FOR NEUROLOGICAL AND NEURODEVELOPMENTAL HEALTH LLC

MEDICARE: THE CENTER FOR NEUROLOGICAL AND NEURODEVELOPMENTAL HEALTH LLC
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
1106S00000XBehavior Technician
22084B0040XBehavioral Neurology & Neuropsychiatry Physician
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1730800194
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CENTER FOR NEUROLOGICAL AND NEURODEVELOPMENTAL HEALTH LLC
Provider Business Mailing Address
First Line : 2050 VOORHEES TOWN CTR
Second Line :
City : VOORHEES
State : NJ
Zip : 08043-1910
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2050 VOORHEES TOWN CTR
Second Line :
City : VOORHEES
State : NJ
Zip : 08043-1910
Country : US
Telephone Number : 856-346-0005
Fax Number :
Authorized Official
Title or Position : CFO
Name : DANIEL CLEMONS
Credential :
Telephone Number : 215-985-4448
Provider Enumeration Date : 09/06/2022
Last Update Date : 09/21/2022

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Directions to “THE CENTER FOR NEUROLOGICAL AND NEURODEVELOPMENTAL HEALTH LLC ” Practice Location

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