Center For Neurologic Specialty
Psychiatry & Neurology, Neurology in Marlton, NJ. Organization (NPI-2).
NPI number1972782704
StatusActive
Last updated in NPPESFeb 6, 2009
Details
- NPI
- 1972782704
- Entity type
- Organization (NPI-2)
- Legal business name
- Center For Neurologic Specialty
- Organization subpart
- No
- Enumeration date
- Oct 29, 2007
- Last updated
- Feb 6, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | MA59597 | NJ | Yes |
Practice location
12000 Lincoln Dr WSuite 204
Marlton, NJ 08053-3402
Phone 856-988-3444 · Fax 856-988-0553
Mailing address
53 Normandy RdMarlton, NJ 08053-5527
Phone 856-988-3444 · Fax 856-988-0553
Authorized official
Ricardo Y Mabanta
Partner
8569883444
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