Provider Demographics
NPI:1730180654
Name:NEUROLOGIC ARTS ASSOCIATED, LLC
Entity type:Organization
Organization Name:NEUROLOGIC ARTS ASSOCIATED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEINTRAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-300-0579
Mailing Address - Street 1:183 HIGH ST
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-9601
Mailing Address - Country:US
Mailing Address - Phone:973-300-0579
Mailing Address - Fax:973-300-5535
Practice Address - Street 1:183 HIGH ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-9601
Practice Address - Country:US
Practice Address - Phone:973-300-0579
Practice Address - Fax:973-300-5535
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEUROLOGIC ARTS ASSOCIATED, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-02
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ106323Medicare UPIN