Healthcare Provider Details

I. General information

NPI: 1386561116
Provider Name (Legal Business Name): TRANSFORM YOUR HEALTH NJ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 ROUTE 10 STE 3
WHIPPANY NJ
07981-2115
US

IV. Provider business mailing address

PO BOX 606
FLEMINGTON NJ
08822-0606
US

V. Phone/Fax

Practice location:
  • Phone: 973-210-3838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SAM ORTIZ
Title or Position: MANAGER
Credential:
Phone: 973-210-3838