NPIMap

Organization Active NPI

Eastern Neurodiagnostic Assoc PC

  • Neurology Physician
  • Voorhees, NJ
National Provider Identifier
1023177102
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
EASTERN NEURODIAGNOSTIC ASSOC PC
Practice address
2301 E Evesham Rd
Pavillion 800 Suite 209
Voorhees, NJ 08043-4501
Phone
(856) 651-0060
Fax
(856) 651-0061
NPI assigned
Dec 6, 2006
Last updated
Feb 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Shiva Gopal Vasishta, MDNPI 1932269982
Title
President
Phone
(856) 651-0060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

2301 E Evesham Rd
Pavillion 800 Suite 209
Voorhees, NJ 08043-4501

Mailing address

2301 E Evesham Rd
Pavillion 800 Suite 209
Voorhees, NJ 08043-4501
Phone (856) 651-0060

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1023177102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 E EVESHAM RD",
            "address_2": "PAVILLION 800 SUITE 209",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434501",
            "telephone_number": "856-651-0060",
            "fax_number": "856-651-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E EVESHAM RD",
            "address_2": "PAVILLION 800 SUITE 209",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434501",
            "telephone_number": "856-651-0060",
            "fax_number": "856-651-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN NEURODIAGNOSTIC ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "VASISHTA",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_middle_name": "GOPAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-651-0060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.