# RUTGERS HEALTH-RWJ NEUROSURGERY FACULTY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rutgers Health-RWJ Pediatric Neurosurgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659406957
- **Authorized official:** BRENDA LAWRENCE (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (732) 235-6070

## Contact information

- **Practice address:** 1 ROBERT WOOD JOHNSON PL STE 2100, NEW BRUNSWICK, NJ 08901-1928
- **Practice address phone:** (732) 235-7044
- **Mailing address:** 66 W GILBERT ST, RED BANK, NJ 07701
- **Mailing address phone:** (732) 212-0051
- **Mailing address fax:** (732) 212-0713

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 01/19/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 352184829 | TAX ID | — |