Healthcare Provider Details

I. General information

NPI: 1669820718
Provider Name (Legal Business Name): WISE BIRTH CHOICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 FLETCHER DR
MORGANVILLE NJ
07751-1404
US

IV. Provider business mailing address

15 FLETCHER DR
MORGANVILLE NJ
07751-1404
US

V. Phone/Fax

Practice location:
  • Phone: 732-754-9551
  • Fax:
Mailing address:
  • Phone: 732-754-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code374K00000X
TaxonomyReligious Nonmedical Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: JILL S DILLNER
Title or Position: PRESIDENT
Credential:
Phone: 732-754-9551