Provider Demographics
NPI:1023615168
Name:WELL HEALTH MEDICAL PRACTICE INC
Entity type:Organization
Organization Name:WELL HEALTH MEDICAL PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNABE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-824-1856
Mailing Address - Street 1:121 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:PORT READING
Mailing Address - State:NJ
Mailing Address - Zip Code:07064-1003
Mailing Address - Country:US
Mailing Address - Phone:732-824-1856
Mailing Address - Fax:
Practice Address - Street 1:676 AMBOY AVE STE 4
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-3144
Practice Address - Country:US
Practice Address - Phone:732-969-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty