Organization
BRAIN INSTITUTE OF NORTHERN NEW JERSEY PA
Active
Organization
BRAIN INSTITUTE OF NORTHERN NEW JERSEY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA SHAJENKO MD, PHD (PRESIDENT)
(646) 712-1635
Entity
Organization
Contact information
Practice address
8 S MORRIS ST, SUITE 302, DOVER, NJ 07801-4649
(646) 712-1635
(866) 267-8173
Mailing address
725 RIVER RD, SUITE 106, EDGEWATER, NJ 07020-1171
(646) 712-1635
(866) 267-8173
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
25MA08061700
NJ
Other
Enumeration date
08/22/2011
Last updated
08/22/2011
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