Organization Active NPI

General Neurology and Headache Disorders, P.a.

  • Medical Specialty Clinic/Center
  • Edison, NJ
National Provider Identifier
1114064144
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
GENERAL NEUROLOGY AND HEADACHE DISORDERS, P.A.
Practice address
2 Lincoln Hwy
Suite 509
Edison, NJ 08820-3961
Phone
(732) 767-1500
Fax
(732) 767-0090
NPI assigned
Jan 31, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Marina Sobol, M.D.NPI 1841344694
Title
Owner
Phone
(732) 767-1500

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
Medical Specialty Clinic/Center 261QM2500X NJ Primary

Addresses

Primary practice location

2 Lincoln Hwy
Suite 509
Edison, NJ 08820-3961

Mailing address

2 Lincoln Hwy
Suite 509
Edison, NJ 08820-3961
Phone (732) 767-1500

Other identifiers 1

IdentifierTypeStateIssuer
0042099MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050401000011 NJ Part B Supplier - Clinic/Group Practice 8820045982 Receives reassigned benefits from 2 practitioners
Practice locations: Edison, NJ; Perth Amboy, NJ

National Provider Directory

National Provider Directory

Locations

42 Parsonage Rd
#B
Edison, NJ 08837
Phone (732) 767-1500

Practitioners & affiliated clinicians

Practitioners 2

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": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114064144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LINCOLN HWY",
            "address_2": "SUITE 509",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203961",
            "telephone_number": "732-767-1500",
            "fax_number": "732-767-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LINCOLN HWY",
            "address_2": "SUITE 509",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203961",
            "telephone_number": "732-767-1500",
            "fax_number": "732-767-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL NEUROLOGY AND HEADACHE DISORDERS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SOBOL",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-767-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0042099",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.