Healthcare Provider Details

I. General information

NPI: 1306291786
Provider Name (Legal Business Name): JERSEY INTEGRATIVE HEALTH & WELLNESS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 US HIGHWAY 46 STE 300
WAYNE NJ
07470-6836
US

IV. Provider business mailing address

155 US HIGHWAY 46 STE 300
WAYNE NJ
07470-6836
US

V. Phone/Fax

Practice location:
  • Phone: 862-666-9285
  • Fax: 862-666-9287
Mailing address:
  • Phone: 862-666-9285
  • Fax: 862-666-9287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE S CAMPOS
Title or Position: OFFICE OWNER
Credential: MD
Phone: 862-666-9285