NPIMap

Organization Active NPI

Neuropractice PC

  • Neurology Physician
  • Old Bridge, NJ
National Provider Identifier
1902142797
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA08800000 Issued in NJ
Legal business name
NEUROPRACTICE PC
Practice address
3901 Highway 516
Suite 1C
Old Bridge, NJ 08857-4900
Phone
(732) 306-7372
Fax
(732) 707-4101
NPI assigned
Dec 24, 2012
Last updated
Dec 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Authorized official

Name
Irina KoganNPI 1679730477
Title
President
Phone
(732) 306-7372

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MA08800000 NJ Primary

Addresses

Primary practice location

3901 Highway 516
Suite 1C
Old Bridge, NJ 08857-4900

Mailing address

445 Kings Highway
2 Floor
Brooklyn, NY 11229-1780
Phone (718) 676-0111

National Provider Directory

National Provider Directory

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": "1356307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1902142797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 KINGS HIGHWAY",
            "address_2": "2 FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291780",
            "telephone_number": "718-676-0111",
            "fax_number": "718-676-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 HIGHWAY 516",
            "address_2": "SUITE 1C",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088574900",
            "telephone_number": "732-306-7372",
            "fax_number": "732-707-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-24",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "KOGAN",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-306-7372"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA08800000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.