Provider Demographics
NPI:1992753594
Name:NEUROSURGICAL ASSOCIATES OF NEW JERSEY, P.C.
Entity type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES OF NEW JERSEY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-327-8600
Mailing Address - Street 1:1200 E RIDGEWOOD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3937
Mailing Address - Country:US
Mailing Address - Phone:201-327-8600
Mailing Address - Fax:212-305-3629
Practice Address - Street 1:1200 E RIDGEWOOD AVE STE 200
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3937
Practice Address - Country:US
Practice Address - Phone:201-327-8600
Practice Address - Fax:201-327-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ601066Medicare ID - Type UnspecifiedGROUP PRACTICE