Healthcare Provider Details

I. General information

NPI: 1295192532
Provider Name (Legal Business Name): MAXIMUM HEALTH & WELLNESS FLORHAM PARK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2016
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 ROUTE 46
LEDGEWOOD NJ
07852-9535
US

IV. Provider business mailing address

PO BOX 138
EAST HANOVER NJ
07936-0138
US

V. Phone/Fax

Practice location:
  • Phone: 862-251-7395
  • Fax: 862-251-7397
Mailing address:
  • Phone: 862-251-7395
  • Fax: 862-251-7397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER CARROLL
Title or Position: OFFICE REP
Credential:
Phone: 833-789-3227