Healthcare Provider Details

I. General information

NPI: 1033084652
Provider Name (Legal Business Name): THRIVIO HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E 1ST AVE
ROSELLE NJ
07203-1301
US

IV. Provider business mailing address

335 GEORGE ST STE 4
NEW BRUNSWICK NJ
08901-4080
US

V. Phone/Fax

Practice location:
  • Phone: 848-305-7071
  • Fax:
Mailing address:
  • Phone: 848-305-7071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: VANESSA EZEMADU
Title or Position: FOUNDER,CEO
Credential:
Phone: 848-305-7071