Healthcare Provider Details

I. General information

NPI: 1952239402
Provider Name (Legal Business Name): EMPOWER U WELLNESS NETWORKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 209TH ST UNIT 2
BAYSIDE NY
11360-1128
US

IV. Provider business mailing address

43 GRAND COVE WAY
EDGEWATER NJ
07020-7223
US

V. Phone/Fax

Practice location:
  • Phone: 908-907-7777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. MARLON GRAY
Title or Position: OWNER
Credential:
Phone: 908-907-7777