Active NPI
The New Jersey Institute of Neurbehavior
- Clinical Neuropsychologist
- Basking Ridge, NJ
National Provider Identifier
1083727622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 1838
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 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 Neurbehavior
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Neuropsychologist
- Basking Ridge, NJ
- NPI 1033314133
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.