Healthcare Provider Details

I. General information

NPI: 1316175706
Provider Name (Legal Business Name): THE CENTER FOR OPTIMUM HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 06/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 FRANKLIN AVE
BELLEVILLE NJ
07109-1552
US

IV. Provider business mailing address

567 FRANKLIN AVE
BELLEVILLE NJ
07109-1552
US

V. Phone/Fax

Practice location:
  • Phone: 973-450-1003
  • Fax: 973-450-5302
Mailing address:
  • Phone: 973-450-1003
  • Fax: 973-450-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL FRANK STEFANELLI
Title or Position: PRESIDENT
Credential: DC,DACNB,MS
Phone: 973-450-1003