SOUTH JERSEY NEUROCARE PA (NPI# 1265416317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265416317 |
| Entity Type | Organization |
| Organization Name | SOUTH JERSEY NEUROCARE PA |
| Practice Address |
520 Stokes Rd Suite A-4 Medford NJ 08055-2904 |
| Practice Telephone | 6097147774 |
| Practice Fax Number | 6097147775 |
| Mailing Telephone | 6097147774 |
| Mailing Fax Number | 6097147775 |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2011-05-18 |
| Authorized Official Name | DR. DAVID CHARLES LEE (PRESIDENT) |
| Authorized Official Telephone | 6097147774 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
49817 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
520 STOKES RD SUITE A-4 |
| City | MEDFORD |
| State | NJ |
| Zip Code | 08055-2904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114200912 | Medford Children's Dental Center, PC | Dentist | 520 Stokes Rd, Suite B 18, Medford, NJ 08055-2904 | 2011-09-28 |
| 1861623977 | Elizabeth M. Raymond | Psychologist | 520 Stokes Rd, Suite B6, Medford, NJ 08055-2904 | 2009-08-06 |
| 1366618308 | Michael John Adornetto | Social Worker | 520 Stokes Rd, Suite C-4, Medford, NJ 08055-2904 | 2008-04-30 |
| 1235229485 | Erika E Ryan | Psychologist | 520 Stokes Rd, Ironstone Building A6, Medford, NJ 08055-2904 | 2006-10-16 |
| 1750489068 | Peter Duca | Dentist | 520 Stokes Rd, Building B-18, Medford, NJ 08055-2904 | 2006-09-20 |
| 1639286115 | Peter R. Duca, Jr., Dmd PC | Dentist | 520 Stokes Rd, Building B-18, Medford, NJ 08055-2904 | 2006-08-23 |
| 1811002025 | Jason Okuley | Dentist | 520 Stokes Rd, Building B-18, Medford, NJ 08055-2904 | 2006-08-20 |
| 1306951546 | Suburban Family Dental PC | Dentist | 520 Stokes Rd, Building B-18, Medford, NJ 08055-2904 | 2006-08-20 |
| 1659383602 | Advocare, LLC | Pediatrics | 520 Stokes Rd, Bldg. B10, Medford, NJ 08055-2904 | 2006-08-11 |
| 1649211327 | Lawrence Frank Vernamonti | Optometrist | 520 Stokes Rd, Suite B4, Medford, NJ 08055-2904 | 2006-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215406459 | Natalia Eltabaa | Nurse Practitioner | 143b Atsion Rd, Medford, NJ 08055 | 2018-11-16 |
| 1922574326 | Emily G Wilkins | Psychiatry & Neurology | 239 Taunton, A-2, Medford, NJ 08055 | 2018-10-23 |
| 1508348863 | Gerald D Mingin Jr. | Psychologist | 135 Eayrestown Rd. Suite A, Southampton, NJ 08055 | 2018-09-04 |
| 1316465750 | Gabriella Marie Francis | Specialist/Technologist | 133 Apache Trail, Medford Lakes, NJ 08055 | 2017-09-06 |
| 1265968572 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 609 Eugenia, Medford, NJ 08055 | 2017-05-05 |
| 1326574690 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1503 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1780110007 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1610 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1902332216 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1909 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1083140396 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 503 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
| 1457887762 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 905 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
| Find all providers in zip 08055 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659519767 | Cynthia Shearn Tainsh | Psychiatry & Neurology | 97 Westwood Rd, Medford, MA 02155-1637 | 2009-01-27 |
| 1528217460 | Christopher Dardis | Psychiatry & Neurology | 2900 State St Ste 101, Medford, OR 97504-8458 | 2008-09-16 |
| 1225249675 | Bruce Ehrenberg | Psychiatry & Neurology | 4 Colby St, Medford, MA 02155-6013 | 2007-05-25 |
| 1366658627 | Nishant Singh Ranawat | Psychiatry & Neurology | Asante Rogue Regional Medical Center, 2825 E Barnett Road, Medford, OR 97504 | 2007-05-15 |
| 1922143296 | Eugenia Blank | Psychiatry & Neurology | 170 Governors Ave Ste 258, Medford, MA 02155-1643 | 2007-02-21 |
| 1912963661 | Larry Jou Maukonen | Psychiatry & Neurology | 897 Royal Ave, Suite B, Medford, OR 97504 | 2006-04-21 |
| 1063412427 | Oscar Adolfo Sanchez | Psychiatry & Neurology | 520 Medical Center Drive, Medford, OR 97504 | 2005-07-28 |
| 1720424591 | Minji Kim | Psychiatry & Neurology | 920 Royal Ave, Medford, OR 97504-6169 | 2013-05-20 |
| 1578821013 | Sabre Amira Patton-fee | Psychiatry & Neurology | 920 Royal Ave, Medford, OR 97504 | 2012-05-02 |
| 1689955536 | Pawani Sachar | Psychiatry & Neurology | 920 Royal Ave, Medford, OR 97504-6169 | 2011-09-06 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.