| Tristate Medical And Wellness, Llc | |
|
19 Hathaway Ln Verona NJ 07044-2306 | |
| (917) 294-4620 | |
| Not Available |
| Full Name | Tristate Medical And Wellness, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 19 Hathaway Ln, Verona, New Jersey |
| Authorized Official Name and Position | Jeannette Gonzalez Simon (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9172944620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tristate Medical And Wellness, Llc 19 Hathaway Ln Verona NJ 07044-2306 Ph: () - | Tristate Medical And Wellness, Llc 19 Hathaway Ln Verona NJ 07044-2306 Ph: (917) 294-4620 |
| NPI Number | 1932707452 |
|---|---|
| Provider Enumeration Date | 10/16/2020 |
| Last Update Date | 10/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932707452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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