| Jersey Shore Mental Wellness Llc. | |
|
2640 Highway 70 Ste 10 Manasquan NJ 08736-2612 | |
| (732) 612-3188 | |
| Not Available |
| Full Name | Jersey Shore Mental Wellness Llc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2640 Highway 70 Ste 10, Manasquan, New Jersey |
| Authorized Official Name and Position | Jacqueline Marie Iannacone (OWNER) |
| Authorized Official Contact | 6097135540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jersey Shore Mental Wellness Llc. 2640 Highway 70 Ste 10 Manasquan NJ 08736-2612 Ph: (732) 612-3188 | Jersey Shore Mental Wellness Llc. 2640 Highway 70 Ste 10 Manasquan NJ 08736-2612 Ph: (732) 612-3188 |
| NPI Number | 1770369647 |
|---|---|
| Provider Enumeration Date | 09/06/2023 |
| Last Update Date | 09/06/2023 |
| Certification Date | 09/06/2023 |
| Medicare PECOS PAC ID | 5193170199 |
|---|---|
| Medicare Enrollment ID | O20231011002193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770369647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jacqueline Iannacone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316675531 PECOS PAC ID: 7911354477 Enrollment ID: I20231011002176 |
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