Provider Demographics
NPI:1447676630
Name:CENTRAL JERSEY NEUROPHYSIOLOGY LLC
Entity type:Organization
Organization Name:CENTRAL JERSEY NEUROPHYSIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:WASIF
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-833-2356
Mailing Address - Street 1:991 US HIGHWAY 22 STE 200
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2957
Mailing Address - Country:US
Mailing Address - Phone:732-595-7772
Mailing Address - Fax:
Practice Address - Street 1:991 US HIGHWAY 22 STE 200
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2957
Practice Address - Country:US
Practice Address - Phone:732-595-7772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-12
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1432174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty