Healthcare Provider Details

I. General information

NPI: 1942429238
Provider Name (Legal Business Name): INTEGRATIVE WELLNESS CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 BRIGHTON RD
CLIFTON NJ
07012-1400
US

IV. Provider business mailing address

164 BRIGHTON RD
CLIFTON NJ
07012-1400
US

V. Phone/Fax

Practice location:
  • Phone: 973-773-2500
  • Fax: 973-773-0508
Mailing address:
  • Phone: 973-773-2500
  • Fax: 973-773-0508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number25MB07663200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number25MB07663200
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number25MB07663200
License Number StateNJ

VIII. Authorized Official

Name: DR. ALBERT J POGORELEC JR.
Title or Position: OWNER
Credential: D.O.
Phone: 973-773-2500