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General NPI Number Information
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NPI Number | 1134703648
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Entity Type | Organization
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Legal Business Name | WELL PRIMARY CARE SERVICES
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 853 MILL CREEK RD
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-0805
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Country | US
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Telephone | 609-374-4178
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Fax |
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Provider Business Mailing Address
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Address Line | 1495 PAUL BLVD
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-4136
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Country | US
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Telephone | 609-374-4178
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Fax |
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Authorized Official
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Title or Position | APN/OWNER
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Name | DR. KELLEY TOFFOLI
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Credential | DNP, APN-C
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Telephone | 609-374-4178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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