Organization
ADVANCED NEUROMED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE SMITH (CREDENTAILING)
(315) 782-4207
Entity
Organization
Contact information
Practice address
1 DEGRAW AVE, TEANECK, NJ 07666-4000
(617) 823-5231
Mailing address
445 FACTORY ST, WATERTOWN, NY 13601-2729
(315) 782-4207
(315) 782-8699
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
07/31/2020
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