Provider Demographics
NPI:1093109084
Name:SYNAPSE NEUROSCIENCES, LLC
Entity type:Organization
Organization Name:SYNAPSE NEUROSCIENCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SISTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-574-1671
Mailing Address - Street 1:1200 E. RIDGEWOOD AVE.
Mailing Address - Street 2:SUITE 108
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450
Mailing Address - Country:US
Mailing Address - Phone:201-574-1671
Mailing Address - Fax:201-574-0081
Practice Address - Street 1:1200 E. RIDGEWOOD AVE.
Practice Address - Street 2:SUITE 108
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450
Practice Address - Country:US
Practice Address - Phone:201-574-1671
Practice Address - Fax:201-574-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEGGroup - Single Specialty