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General NPI Number Information
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NPI Number | 1427020635
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Entity Type | Organization
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Legal Business Name | FAMILY WELLNESS CENTER PC
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 1680 STATE HWY 35
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City | MIDDLETOWN
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State | NJ
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Zip | 07748
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Country | US
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Telephone | 732-671-3730
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Fax | 732-706-1078
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Provider Business Mailing Address
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Address Line | 1680 STATE HWY 35
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City | MIDDLETOWN
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State | NJ
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Zip | 07748
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Country | US
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Telephone | 732-671-3730
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Fax | 732-706-1078
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Authorized Official
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Title or Position | OWNER
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Name | DAVID B DORNFELD
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Credential | DO
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Telephone | 732-671-3730
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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 | 25MB04895800
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License Number State | NJ
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