Basic Information
Provider Information
NPI: 1023466356
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEHN
FirstName: ANNE
MiddleName:  
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Credential:  
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Mailing Information
Address1: 700 US HIGHWAY 46
Address2: SUITE 420
City: FAIRFIELD
State: NJ
PostalCode: 070041591
CountryCode: US
TelephoneNumber: 9738823456
FaxNumber: 9738823450
Practice Location
Address1: 700 US HIGHWAY 46
Address2: SUITE 420
City: FAIRFIELD
State: NJ
PostalCode: 070041591
CountryCode: US
TelephoneNumber: 9738823456
FaxNumber: 9738823450
Other Information
ProviderEnumerationDate: 05/26/2016
LastUpdateDate: 05/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
246ZE0600X  Y Technologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic

No ID Information.


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