Organization · NPI-2
Prime Neurology LLC
Psychiatry & Neurology, Neurology · Fair Lawn, NJ
NPI number1417620113
StatusActive
Last updated in NPPESFeb 19, 2026
Details
- NPI
- 1417620113
- Entity type
- Organization (NPI-2)
- Legal business name
- Prime Neurology LLC
- Organization subpart
- No
- Enumeration date
- Jul 28, 2021
- Certification date
- Feb 19, 2026
- Last updated
- Feb 19, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | – | – | Yes |
Practice location
15-01 Broadway Ste 32Fair Lawn, NJ 07410-6026
Phone 551-252-5316 · Fax 201-849-7545
Mailing address
15-01 Broadway Ste 32Fair Lawn, NJ 07410-6026
Phone 551-252-5316
Authorized official
Sweta Goel
Physician
3392937686
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