Healthcare Provider Details

I. General information

NPI: 1225229321
Provider Name (Legal Business Name): WELLNESS GROUP OF NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400D LAKE ST SUITE 2
RAMSEY NJ
07446-1279
US

IV. Provider business mailing address

1100 RAHWAY RD
SCOTCH PLAINS NJ
07076-3412
US

V. Phone/Fax

Practice location:
  • Phone: 908-625-2128
  • Fax: 908-754-5907
Mailing address:
  • Phone: 908-625-2128
  • Fax: 908-754-5907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. SUZANNE DRAKE
Title or Position: PRESIDENT
Credential: PHD, APRN
Phone: 908-625-2128