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NPI Code Detail

MEDICARE: MOBILE WELLNESS SERVICES LLC

MEDICARE: MOBILE WELLNESS SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician25MA07696500NJ

General Provider Information

NPI Number : 1104835271
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOBILE WELLNESS SERVICES LLC
Provider Business Mailing Address
First Line : 711 KEARNY AVE
Second Line :
City : KEARNY
State : NJ
Zip : 07032-3003
Country : US
Telephone Number : 888-214-9212
Fax Number : 888-214-9212
Provider Business Practice Location Address
First Line : 711 KEARNY AVE
Second Line :
City : KEARNY
State : NJ
Zip : 07032-3003
Country : US
Telephone Number : 888-214-9212
Fax Number : 888-214-9212
Authorized Official
Title or Position : CEO
Name : DR. ANSAR SHARIF
Credential : MD
Telephone Number : 888-214-9212
Provider Enumeration Date : 08/06/2006
Last Update Date : 08/22/2020

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Directions to “MOBILE WELLNESS SERVICES LLC ” Practice Location

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