Healthcare Provider Details

I. General information

NPI: 1467298745
Provider Name (Legal Business Name): THRIVE MEDICAL AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2024
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 5TH AVE UNIT 105
BELMAR NJ
07719-2162
US

IV. Provider business mailing address

16 WOODVIEW DR
HOWELL NJ
07731-3825
US

V. Phone/Fax

Practice location:
  • Phone: 732-991-2500
  • Fax:
Mailing address:
  • Phone: 732-991-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES MORALES
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 732-991-2500