Healthcare Provider Details

I. General information

NPI: 1285005884
Provider Name (Legal Business Name): NORTH JERSEY HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 DONNY BROOK DR
ALLENDALE NJ
07401-1422
US

IV. Provider business mailing address

227 DONNY BROOK DR
ALLENDALE NJ
07401-1422
US

V. Phone/Fax

Practice location:
  • Phone: 201-819-8545
  • Fax: 805-473-5931
Mailing address:
  • Phone: 201-819-8545
  • Fax: 805-473-5931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number25MA09655600
License Number StateNJ

VIII. Authorized Official

Name: DR. DEREK BRUCE BERBERIAN
Title or Position: OWNER
Credential: MD
Phone: 201-819-8545