Provider Demographics
NPI:1447554001
Name:EPILEPSY AND NEUROLOGY GROUP, LLC
Entity type:Organization
Organization Name:EPILEPSY AND NEUROLOGY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAATREH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-407-6555
Mailing Address - Street 1:9 DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3256
Mailing Address - Country:US
Mailing Address - Phone:732-414-8585
Mailing Address - Fax:732-875-0509
Practice Address - Street 1:901 W MAIN ST
Practice Address - Street 2:SUITE 260, CN5050
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2537
Practice Address - Country:US
Practice Address - Phone:732-414-8585
Practice Address - Fax:732-875-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA080786002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty