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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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