Garden State Neuro Diagnostic Labs, Inc.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

GARDEN STATE NEURO DIAGNOSTIC LABS, INC.

Practice address

201 Woolston Dr
Morrisville, PA 19067-5008

Phone

(215) 736-8930

Fax

(215) 736-3093

NPI assigned

Dec 22, 2008

Organization subpart

No

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

Authorized official

Name

Connie Lubold

Title

PA

Phone

(215) 736-8930

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229904000000",
    "number": "1053557066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WOOLSTON DR",
            "city": "MORRISVILLE",
            "state": "PA",
            "postal_code": "190675008",
            "telephone_number": "215-736-8930",
            "fax_number": "215-736-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WOOLSTON DR",
            "city": "MORRISVILLE",
            "state": "PA",
            "postal_code": "190675008",
            "telephone_number": "215-736-8930",
            "fax_number": "215-736-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE NEURO DIAGNOSTIC LABS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2008-12-22",
        "status": "A",
        "authorized_official_last_name": "LUBOLD",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "PA",
        "authorized_official_telephone_number": "215-736-8930"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Morrisville, PA
• Providers in Morrisville, PA by specialty
• Neurology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; 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.