Healthcare Provider Details

I. General information

NPI: 1568366789
Provider Name (Legal Business Name): PINNACLE WELLNESS GROUP NJ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 CARYN PL
FAIRFIELD NJ
07004-1801
US

IV. Provider business mailing address

19 CARYN PL
FAIRFIELD NJ
07004-1801
US

V. Phone/Fax

Practice location:
  • Phone: 609-634-1366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: PATRICK MERCER
Title or Position: OWNER
Credential: MS,CES,PES,EP-C,CLC
Phone: 609-634-1366