Provider Demographics
NPI:1144109554
Name:BROMLEY BRAIN & MIND INSTITUTE LLC
Entity type:Organization
Organization Name:BROMLEY BRAIN & MIND INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-278-2088
Mailing Address - Street 1:739 S WHITE HORSE PIKE STE 1
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1659
Mailing Address - Country:US
Mailing Address - Phone:856-546-2300
Mailing Address - Fax:856-546-2301
Practice Address - Street 1:739 S WHITE HORSE PIKE STE 1
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1659
Practice Address - Country:US
Practice Address - Phone:856-546-2300
Practice Address - Fax:856-546-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-29
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty