MEDICARE: A.B.K. NEUROLOGICAL ASSOCIATES, PA

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
1	2084N0400X	Neurology Physician	MA58634	NJ

General Provider Information

NPI Number	:	1962626325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A.B.K. NEUROLOGICAL ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	201 SAINT PAULS AVE
Second Line	:	SUITE 15W
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3724
Country	:	US
Telephone Number	:	201-333-8004
Fax Number	:	201-333-8425

Provider Business Practice Location Address
First Line	:	2757 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5507
Country	:	US
Telephone Number	:	201-333-8004
Fax Number	:	201-333-8425

Authorized Official
Title or Position	:	NEUROLOGIST
Name	:	DR. SAI S.K.R. KOLLA
Credential	:	M.D.
Telephone Number	:	201-333-8004

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	08/22/2020

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