Healthcare Provider Details

I. General information

NPI: 1881344976
Provider Name (Legal Business Name): WELL-AMERICA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 OGLE RD
OLD TAPPAN NJ
07675
US

IV. Provider business mailing address

79 OGLE RD
OLD TAPPAN NJ
07675-7026
US

V. Phone/Fax

Practice location:
  • Phone: 732-485-1301
  • Fax: 848-667-8981
Mailing address:
  • Phone: 732-485-1301
  • Fax: 302-469-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: YASIR J AHMAD
Title or Position: OWNER
Credential: MD
Phone: 732-485-1301