Healthcare Provider Details

I. General information

NPI: 1700137924
Provider Name (Legal Business Name): ADVANCED WELLNESS OF WESTFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 CENTRAL AVE
WESTFIELD NJ
07090-2520
US

IV. Provider business mailing address

439 CENTRAL AVE
WESTFIELD NJ
07090-2520
US

V. Phone/Fax

Practice location:
  • Phone: 908-228-5911
  • Fax: 908-228-5913
Mailing address:
  • Phone: 908-228-5911
  • Fax: 908-228-5913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN PINTO
Title or Position: OWNER
Credential: D.C., B.C.A.O., C.C.
Phone: 703-830-2100