| Eastern Neurodiagnostic Assoc Pc | |
|
2301 E Evesham Rd Pavillion 800 Suite 209 Voorhees NJ 08043-4501 | |
| (856) 651-0060 | |
| (856) 651-0061 |
| Full Name | Eastern Neurodiagnostic Assoc Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2301 E Evesham Rd, Voorhees, New Jersey |
| Authorized Official Name and Position | Shiva Gopal Vasishta (PRESIDENT) |
| Authorized Official Contact | 8566510060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Neurodiagnostic Assoc Pc 2301 E Evesham Rd Pavillion 800 Suite 209 Voorhees NJ 08043-4501 Ph: (856) 651-0060 | Eastern Neurodiagnostic Assoc Pc 2301 E Evesham Rd Pavillion 800 Suite 209 Voorhees NJ 08043-4501 Ph: (856) 651-0060 |
| NPI Number | 1023177102 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 02/04/2013 |
| Medicare PECOS PAC ID | 0749236818 |
|---|---|
| Medicare Enrollment ID | O20050323000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023177102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Alan Kwon |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1043224108 PECOS PAC ID: 9335040161 Enrollment ID: I20040812000291 |
| Provider Name | Cynthia L Boyer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346464476 PECOS PAC ID: 4284673971 Enrollment ID: I20050502001235 |
| Provider Name | Alan D Carr |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184783375 PECOS PAC ID: 0345335246 Enrollment ID: I20071008000379 |
| Provider Name | William R Wolfe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003872912 PECOS PAC ID: 3375544067 Enrollment ID: I20090602000663 |
| Provider Name | Roger M Kurlan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487663159 PECOS PAC ID: 6709926603 Enrollment ID: I20091229000033 |
| Provider Name | Shiva G Vasishta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932269982 PECOS PAC ID: 2264690320 Enrollment ID: I20120221000017 |
| Provider Name | Kisher K Patil |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487741062 PECOS PAC ID: 5597926279 Enrollment ID: I20120406000104 |
| Provider Name | Mary Margaret Epifano |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1386951804 PECOS PAC ID: 5698906881 Enrollment ID: I20140402000061 |
| Provider Name | Rachael E Felsenfeld |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174692149 PECOS PAC ID: 5890717680 Enrollment ID: I20160122001430 |
| Provider Name | Matthew G Mcclure |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1124389028 PECOS PAC ID: 7416254404 Enrollment ID: I20170120000819 |
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