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General NPI Number Information
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NPI Number | 1609044825
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Entity Type | Organization
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Legal Business Name | NEW JERSEY WELLNESS, PC
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 151 N DEAN ST
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2501
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Country | US
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Telephone | 201-567-0700
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Fax | 201-567-3705
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Provider Business Mailing Address
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Address Line | 151 N DEAN ST
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2501
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Country | US
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Telephone | 201-567-0700
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Fax | 201-567-3705
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALAN S PINE
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Credential | DC
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Telephone | 201-567-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | MC001314
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License Number State | NJ
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