NPIMap

Organization Active NPI

Neurorehab Institute LLC

  • Clinical Psychologist
  • Mt Arlington, NJ
National Provider Identifier
1457539595
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35S100448700 Issued in NJ
Legal business name
NEUROREHAB INSTITUTE LLC
Practice address
111 Howard Blvd
Suite 204
Mt Arlington, NJ 07856-1315
Phone
(973) 601-0100
Fax
(973) 398-2211
NPI assigned
Jan 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Nadia Soledad Mendez
Title
Administrator
Phone
(973) 223-7079

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 35SI00333800 NJ
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X SI 03721 NJ
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 35S100448700 NJ Primary

Addresses

Primary practice location

111 Howard Blvd
Suite 204
Mt Arlington, NJ 07856-1315

Mailing address

PO Box 26
Chester, NJ 07930-0026
Phone (973) 601-0100

National Provider Directory

National Provider Directory

Locations

111 Howard Blvd
Ste 204
Mt Arlington, NJ 07856
Phone (973) 223-7079

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1457539595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079300026",
            "telephone_number": "973-601-0100",
            "fax_number": "973-398-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HOWARD BLVD",
            "address_2": "SUITE 204",
            "city": "MT ARLINGTON",
            "state": "NJ",
            "postal_code": "078561315",
            "telephone_number": "973-601-0100",
            "fax_number": "973-398-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROREHAB INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "NADIA",
        "authorized_official_middle_name": "SOLEDAD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "973-223-7079"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00333800",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "SI 03721",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100448700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Arlington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.