Provider Demographics
NPI:1275355596
Name:SYNAPSE WELLNESS
Entity type:Organization
Organization Name:SYNAPSE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSHERIEF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:848-219-1602
Mailing Address - Street 1:32 KOSTER BLVD APT 1B
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-4272
Mailing Address - Country:US
Mailing Address - Phone:848-219-1602
Mailing Address - Fax:
Practice Address - Street 1:629 AMBOY AVE FL 3
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3579
Practice Address - Country:US
Practice Address - Phone:848-219-1602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty