Provider Demographics
NPI:1962849935
Name:GUARDIAN INTRAOPERATIVE NEUROMOMITORING
Entity type:Organization
Organization Name:GUARDIAN INTRAOPERATIVE NEUROMOMITORING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-933-5450
Mailing Address - Street 1:576 VALLEY BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1919
Mailing Address - Country:US
Mailing Address - Phone:201-933-5450
Mailing Address - Fax:201-933-5452
Practice Address - Street 1:576 VALLEY BROOK AVE
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071
Practice Address - Country:US
Practice Address - Phone:201-933-5450
Practice Address - Fax:201-933-5452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC050084261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical