Unknown Individual – Clinical Neuropsychologist, NPI 1962406868

Unknown Individual is a healthcare provider. based in Colonia, New Jersey. specializing in Clinical Neuropsychologist. They hold a License No. 35SI00143300 (NJ). The NPI Number for Unknown Individual is 1962406868

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962406868
Phone
(732) 396-1444
Address
811 INMAN AVE
Deactivation Date
21 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7323961444
Graduation Year
1977 (49 years ago)
PAC ID
5092772426
Professional Enrollment ID
I20041216000655
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 811 INMAN AVE

    COLONIA, NJ 070671433

    Phone: (732) 396-1444

    Fax: (732) 574-3435

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 07067)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1962406868 as the unique 10-digit identifier.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Clinical Neuropsychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Colonia?
Unknown Individual currently maps to Colonia, New Jersey in this extract.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.