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General NPI Number Information
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NPI Number | 1023615168
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Entity Type | Organization
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Legal Business Name | WELL HEALTH MEDICAL PRACTICE INC
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 11/22/2020
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Provider Practice Location Address
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Address Line | 676 AMBOY AVE STE 4
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-3144
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Country | US
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Telephone | 732-969-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 121 DIVISION ST
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City | PORT READING
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State | NJ
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Zip | 07064-1003
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Country | US
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Telephone | 732-824-1856
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA BERNABE
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Credential | MD
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Telephone | 732-824-1856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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