Organization
EPILEPSY & NEUROPHYSIOLOGY MEDICAL CONSULTANTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY INFELD (CREDENTIALING MANAGER)
(914) 428-3651
Entity
Organization
Contact information
Practice address
2 CAPITAL WAY, 3RD FLOOR, SUITE 385, PENNINGTON, NJ 08534-2521
(908) 522-4990
(973) 538-0043
Mailing address
690 N BROADWAY, GL1, N WHITE PLAINS, NY 10603-2417
(914) 428-3651
(914) 428-2648
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084N0400X
Neurology Physician
Primary
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
02/16/2016
Last updated
09/19/2016
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