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General NPI Number Information
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NPI Number | 1245063908
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Entity Type | Organization
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Legal Business Name | NJ OMM
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Dates
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Enumeration Date | 08/20/2024
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 3322 US HIGHWAY 22 STE 1008
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City | BRANCHBURG
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State | NJ
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Zip | 08876-4403
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Country | US
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Telephone | 908-219-7965
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Fax | 866-531-7548
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Provider Business Mailing Address
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Address Line | 3322 US HIGHWAY 22 STE 1008
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City | BRANCHBURG
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State | NJ
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Zip | 08876-4403
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Country | US
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Telephone | 908-219-7965
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Fax | 866-531-7548
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLEE WING QUAN
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Credential | DO
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Telephone | 908-219-7965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number |
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License Number State |
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