Organization Active NPI

The New Jersey Institute of Neurbehavior

  • Clinical Neuropsychologist
  • Basking Ridge, NJ
National Provider Identifier
1083727622
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1838 Issued in NJ
Legal business name
THE NEW JERSEY INSTITUTE OF NEURBEHAVIOR
Practice address
665 Martinsville Rd
Riverwalk Village Center, Suite 218
Basking Ridge, NJ 07920-4700
Phone
(908) 604-1100
Fax
(908) 607-1866
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Bragonier Gillock, ED.D.
Title
Director of Clinical Services
Phone
(908) 604-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 1838 NJ Primary

Addresses

Primary practice location

665 Martinsville Rd
Riverwalk Village Center, Suite 218
Basking Ridge, NJ 07920-4700

Mailing address

665 Martinsville Rd
Riverwalk Village Center, Suite 218
Basking Ridge, NJ 07920-4700
Phone (908) 604-1100

National Provider Directory

National Provider Directory
Tax ID family
The New Jersey Institute of Neurbehavior2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083727622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 MARTINSVILLE RD",
            "address_2": "RIVERWALK VILLAGE CENTER, SUITE 218",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079204700",
            "telephone_number": "908-604-1100",
            "fax_number": "908-607-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 MARTINSVILLE RD",
            "address_2": "RIVERWALK VILLAGE CENTER, SUITE 218",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079204700",
            "telephone_number": "908-604-1100",
            "fax_number": "908-607-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE NEW JERSEY INSTITUTE OF NEURBEHAVIOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILLOCK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BRAGONIER",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "908-604-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "1838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Basking Ridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.