Provider Demographics
NPI:1285056739
Name:ELITE NEUROPHYSIOLOGY
Entity type:Organization
Organization Name:ELITE NEUROPHYSIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:S
Authorized Official - Middle Name:
Authorized Official - Last Name:M
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-595-2444
Mailing Address - Street 1:200 CENTENNIAL AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854
Mailing Address - Country:US
Mailing Address - Phone:732-595-2444
Mailing Address - Fax:
Practice Address - Street 1:200 CENTENNIAL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854
Practice Address - Country:US
Practice Address - Phone:732-595-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-16
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty