Organization
EPILEPSY & NEUROPHYSIOLOGY MEDICAL CONSULTANTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCELO E LANCMAN MD (OWNER)
(914) 428-3651
Entity
Organization
Contact information
Practice address
20 PROSPECT AVE, SUITE 800, HACKENSACK, NJ 07601-1997
(201) 996-3205
(201) 343-6689
Mailing address
333 WESTCHESTER AVE STE E104, WHITE PLAINS, NY 10604-2930
(914) 428-3651
(914) 428-2948
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084N0400X
Neurology Physician
Primary
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0240982
—
NJ
05
—
7832508
—
NJ
Enumeration date
11/09/2005
Last updated
03/04/2022
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