Advanced Neuromed LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

ADVANCED NEUROMED LLC

Practice address

1 Degraw Ave
Teaneck, NJ 07666-4000

Phone

(617) 823-5231

NPI assigned

Jul 8, 2020

Last updated

Jul 31, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charlotte Smith

Title

Credentailing

Phone

(315) 782-4207

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1447878277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 FACTORY ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012729",
            "telephone_number": "315-782-4207",
            "fax_number": "315-782-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEGRAW AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664000",
            "telephone_number": "617-823-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED NEUROMED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "CREDENTAILING",
        "authorized_official_telephone_number": "315-782-4207"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "network",
            "affiliation": "N",
            "address_1": "1 DeGraw Ave",
            "city": "Teaneck",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076664000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "URL",
            "affiliation": "N",
            "address_1": "1 DeGraw Ave",
            "city": "Teaneck",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076664000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Jeanine Linda Ahmad

• Neurology Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.