Healthcare Provider Details

I. General information

NPI: 1336994383
Provider Name (Legal Business Name): PEAK MEDICAL & WELLNESS CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2024
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 ROBIN RD STE 118
PARAMUS NJ
07652-1424
US

IV. Provider business mailing address

PO BOX 629
FRANKLIN LAKES NJ
07417-0629
US

V. Phone/Fax

Practice location:
  • Phone: 201-225-1511
  • Fax:
Mailing address:
  • Phone: 201-847-8079
  • Fax: 201-847-0059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: KLEJDJA ALBERT
Title or Position: DIRECTOR
Credential: DPT
Phone: 201-225-1511