Organization Active NPI

United Neuro Diagnostic Services, LLC

  • Electroneurodiagnostic Specialist/Technologist
  • Wayne, NJ
National Provider Identifier
1356082374
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
Legal business name
UNITED NEURO DIAGNOSTIC SERVICES, LLC
Practice address
401 Hamburg Tpke Ste 205
Wayne, NJ 07470-2139
Phone
(973) 633-0070
Fax
(973) 633-0706
NPI assigned
Apr 5, 2022
Last updated
Aug 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Authorized official

Name
Teejan Wojohk, ABRET
Title
Director Chief Technologist
Phone
(973) 633-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZE0600X Primary

Addresses

Primary practice location

401 Hamburg Tpke Ste 205
Wayne, NJ 07470-2139

Mailing address

401 Hamburg Tpke Ste 205
Wayne, NJ 07470-2139
Phone (973) 633-0070

Other identifiers 1

IdentifierTypeStateIssuer
1235426347OtherNJDR DANI KORYA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dciavarella@unitedneuro.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221011000079 NJ Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4587040845 Practice locations: Wayne, NJ

National Provider Directory

National Provider Directory

Locations

401 Hamburg Tpke
Ste 205
Wayne, NJ 07470
Phone (201) 996-3205

Practitioners & affiliated clinicians

Practitioners 1

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": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1356082374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE STE 205",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702139",
            "telephone_number": "973-633-0070",
            "fax_number": "973-633-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE STE 205",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702139",
            "telephone_number": "973-633-0070",
            "fax_number": "973-633-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED NEURO DIAGNOSTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "WOJOHK",
        "authorized_official_first_name": "TEEJAN",
        "authorized_official_title_or_position": "DIRECTOR CHIEF TECHNOLOGIST",
        "authorized_official_telephone_number": "973-633-0700",
        "authorized_official_credential": "ABRET"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR DANI KORYA",
            "identifier": "1235426347",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dciavarella@unitedneuro.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "401 Hamburg Turnpike",
            "address_2": "Suite 205",
            "city": "Wayne",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "07470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.