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General NPI Number Information
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NPI Number | 1063021244
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Entity Type | Organization
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Legal Business Name | PINNACLE WELLNESS PC
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 193 US HIGHWAY 9 STE 2A
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City | MANALAPAN
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State | NJ
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Zip | 07726-3016
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Country | US
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Telephone | 718-268-8383
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Fax |
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Provider Business Mailing Address
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Address Line | 193 US HIGHWAY 9 STE 2A
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City | MANALAPAN
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State | NJ
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Zip | 07726-3016
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Country | US
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Telephone | 718-268-8383
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GARY GUARNACCIA
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Credential | MD
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Telephone | 718-268-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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