Nissi IV Hydration Therapy and Wellness Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NISSI IV HYDRATION THERAPY AND WELLNESS CLINIC LLC

Practice address

15 W Prospect St Ste 3
East Brunswick, NJ 08816-2161

Phone

(732) 301-4465

Fax

(732) 301-4492

NPI assigned

Nov 15, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amanda Adiyia, FNPNPI 1295339398

Title

Owner,Administrator

Phone

(732) 301-4465

Specialties & licenses 2

Addresses

Other names 1

• Nissi Wellness Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Adiyia, APN

  • Nurse Practitioner
  • East Brunswick, NJ
  • NPI 1295339398

  NJ

  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1245005669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W PROSPECT STREET SUITE 3",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088168578",
            "telephone_number": "732-301-4465",
            "fax_number": "732-301-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W PROSPECT ST STE 3",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162161",
            "telephone_number": "732-301-4465",
            "fax_number": "732-301-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISSI IV HYDRATION THERAPY AND WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-15",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "ADIYIA",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER,ADMINISTRATOR",
        "authorized_official_telephone_number": "732-301-4465",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nissi Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nissi Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in East Brunswick, NJ
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.