Provider Demographics
NPI: | 1407152960 |
---|---|
Name: | NEUROTEC NEUROLOGY ASSOCIATES, PA |
Entity type: | Organization |
Organization Name: | NEUROTEC NEUROLOGY ASSOCIATES, PA |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/CEO |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | BRAD |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | TINKELMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 973-451-0126 |
Mailing Address - Street 1: | 55 MADISON AVE |
Mailing Address - Street 2: | SUITE 400 |
Mailing Address - City: | MORRISTOWN |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07960-7337 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 973-451-0126 |
Mailing Address - Fax: | 973-451-0127 |
Practice Address - Street 1: | 55 MADISON AVE |
Practice Address - Street 2: | SUITE 400 |
Practice Address - City: | MORRISTOWN |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 07960-7337 |
Practice Address - Country: | US |
Practice Address - Phone: | 973-451-0126 |
Practice Address - Fax: | 973-451-0127 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-02-01 |
Last Update Date: | 2011-02-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 204D00000X | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM | Group - Single Specialty |