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General NPI Number Information
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NPI Number | 1285964676
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Entity Type | Organization
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Legal Business Name | JERSEY SHORE INSTITUTE OF HEALTH AND WELLNESS
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Dates
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Enumeration Date | 01/06/2010
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 2051 HWY 35
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City | WALL TOWNSHIP
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State | NJ
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Zip | 07719-3539
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Country | US
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Telephone | 732-722-7500
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Fax | 732-722-7497
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Provider Business Mailing Address
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Address Line | 2051 HWY 35
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City | WALL TOWNSHIP
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State | NJ
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Zip | 07719-3539
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Country | US
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Telephone | 732-722-7500
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Fax | 732-722-7497
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARISA ANZEVINO
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Credential |
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Telephone | 732-722-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00398600
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License Number State | NJ
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