Organization
EASTERN NEURODIAGNOSTIC ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIVA GOPAL VASISHTA MD (PRESIDENT)
(856) 651-0060
Entity
Organization
Contact information
Practice address
2301 E EVESHAM RD, PAVILLION 800 SUITE 209, VOORHEES, NJ 08043-4501
(856) 651-0060
(856) 651-0061
Mailing address
2301 E EVESHAM RD, PAVILLION 800 SUITE 209, VOORHEES, NJ 08043-4501
(856) 651-0060
(856) 651-0061
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
12/06/2006
Last updated
02/04/2013
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