Healthcare Provider Details

I. General information

NPI: 1003737933
Provider Name (Legal Business Name): INNER-PEACE PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 HORIZON DR APT 201
EDISON NJ
08817-5781
US

IV. Provider business mailing address

603 HORIZON DR APT 201
EDISON NJ
08817-5781
US

V. Phone/Fax

Practice location:
  • Phone: 848-209-1062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOAN WAMAHIU
Title or Position: MANAGER
Credential:
Phone: 848-209-1062