| Neurophysiologic Interpretive Medicine Pllc | |
|
700 Us Highway 46 Suite 420 Fairfield NJ 07004-1591 | |
| (973) 882-3456 | |
| (973) 882-3450 |
| Full Name | Neurophysiologic Interpretive Medicine Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 700 Us Highway 46, Fairfield, New Jersey |
| Authorized Official Name and Position | Marcos J Cruz (OWNER) |
| Authorized Official Contact | 9738823456 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurophysiologic Interpretive Medicine Pllc 700 Us Highway 46 Suite 420 Fairfield NJ 07004-1591 Ph: (973) 882-3456 | Neurophysiologic Interpretive Medicine Pllc 700 Us Highway 46 Suite 420 Fairfield NJ 07004-1591 Ph: (973) 882-3456 |
| NPI Number | 1316256167 |
|---|---|
| Provider Enumeration Date | 09/28/2010 |
| Last Update Date | 04/22/2015 |
| Medicare PECOS PAC ID | 2567617616 |
|---|---|
| Medicare Enrollment ID | O20130221000459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316256167 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 2565911 (New York) | Primary |
| Provider Name | Marcos Cruz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265556898 PECOS PAC ID: 3870652472 Enrollment ID: I20130322000275 |
| Provider Name | Steven Daniel Factor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730472408 PECOS PAC ID: 8325327703 Enrollment ID: I20161121002161 |
| Provider Name | Lori Ilyse Gerber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235393109 PECOS PAC ID: 2163560103 Enrollment ID: I20161121002250 |
| Provider Name | Steven Urbaniak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891774634 PECOS PAC ID: 5395827299 Enrollment ID: I20190319000541 |
| Provider Name | Sarah Zubkov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215262720 PECOS PAC ID: 0749596567 Enrollment ID: I20190328002198 |
| Provider Name | Ruby Upadhyay Reid |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700128287 PECOS PAC ID: 5890086417 Enrollment ID: I20191025000623 |
| Provider Name | Seth David Scholl |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1245262922 PECOS PAC ID: 3577507151 Enrollment ID: I20191210001631 |
| Provider Name | Breyanna Grays |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942560800 PECOS PAC ID: 3274825641 Enrollment ID: I20201216002784 |
| Provider Name | Thai Son Dang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023514122 PECOS PAC ID: 0648667030 Enrollment ID: I20230706001827 |
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