Healthcare Provider Details
I. General information
NPI: 1821915364
Provider Name (Legal Business Name): MK WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
715 BROADWAY STE 2
PATERSON NJ
07514-3405
US
IV. Provider business mailing address
715 BROADWAY STE 2
PATERSON NJ
07514-3405
US
V. Phone/Fax
- Phone: 973-914-8123
- Fax:
- Phone: 973-914-8123
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MERSIHA
KONJHODZIC
Title or Position: OWNER
Credential: L. AC
Phone: 973-914-8123