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General NPI Number Information
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NPI Number | 1649880022
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Entity Type | Organization
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Legal Business Name | MAPLEWOOD WELLNESS CENTER
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 2040 MILLBURN AVE STE 405
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3716
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Country | US
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Telephone | 973-379-3688
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 MILLBURN AVE STE 405
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3716
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Country | US
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Telephone | 973-379-3688
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Fax |
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Authorized Official
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Title or Position | MD
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Name | NINGNING HE
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Credential |
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Telephone | 908-723-6901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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