Wellness Consultation Services LLC

Organization Active NPI Multi-Specialty Clinic/Center · South River, NJ

NPI 1306089792 · NPPES record last updated Apr 14, 2009

Key facts

NPI
1306089792
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
License
00634638 (IL)
Legal business name
WELLNESS CONSULTATION SERVICES LLC
Practice address
8 Old Bridge Tpke
South River, NJ 08882-2400
Phone
(732) 390-4888
Fax
(732) 390-0255
NPI assigned
Apr 14, 2009
Organization subpart
No

Authorized official

Name
Mrs. Betsy Rochelle Dubov, REGISTERED DIETITIAN
Title
President
Phone
(732) 816-1651

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090605000046 NJ Part B Supplier - Clinic/Group Practice 8527118918 Receives reassigned benefits from 1 practitioner
Practice locations: South River, NJ

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 00634638 IL Yes

Addresses

Primary practice location

8 Old Bridge Tpke
South River, NJ 08882-2400

Mailing address

6 Aspen CT
East Brunswick, NJ 08816-3345
Phone (732) 816-1651

Other identifiers

IdentifierTypeStateIssuer
053650OtherNJMEDICARE PROVIDER NUMBER

Other providers in South River, NJ

All providers in South River, NJ · Multi-Specialty Clinic/Center in New Jersey

Sources for this page

Verify at the official NPI Registry.