Provider Demographics
NPI:1063407674
Name:NEUROLOGY GROUP OF NORTH JERSEY PA
Entity type:Organization
Organization Name:NEUROLOGY GROUP OF NORTH JERSEY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:KNEP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-471-3680
Mailing Address - Street 1:905 ALLWOOD RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1946
Mailing Address - Country:US
Mailing Address - Phone:973-471-3680
Mailing Address - Fax:973-471-6360
Practice Address - Street 1:905 ALLWOOD RD
Practice Address - Street 2:SUITE 105
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1946
Practice Address - Country:US
Practice Address - Phone:973-471-3680
Practice Address - Fax:973-471-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2675901Medicaid
526253Medicare PIN