Organization Active NPI

Energy Wellness & Fitness Inc

  • Chiropractor
  • Teaneck, NJ
National Provider Identifier
1356440010
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MCO3019 Issued in NJ
Legal business name
ENERGY WELLNESS & FITNESS INC
Practice address
244 Johnson Ave
Teaneck, NJ 07666-3309
Phone
(201) 836-9558
Fax
(201) 836-7967
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Authorized official

Name
Peter Anthony Gratale, D.C.NPI 1871692533
Title
Ceo
Phone
(201) 836-9558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X MCO3019 NJ Primary

Addresses

Primary practice location

244 Johnson Ave
Teaneck, NJ 07666-3309

Mailing address

244 Johnson Ave
Teaneck, NJ 07666-3309
Phone (201) 836-9558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070913000149 NJ Part B Supplier - Clinic/Group Practice 1759475353 Receives reassigned benefits from 1 practitioner
Practice locations: Teaneck, NJ

National Provider Directory

National Provider Directory

Locations

244 Johnson Ave
Teaneck, NJ 07666
Phone (201) 836-9558

764 Palisade Ave
Lowr
Teaneck, NJ 07666
Phone (201) 836-9558

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1356440010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 JOHNSON AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663309",
            "telephone_number": "201-836-9558",
            "fax_number": "201-836-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 JOHNSON AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663309",
            "telephone_number": "201-836-9558",
            "fax_number": "201-836-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGY WELLNESS & FITNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "GRATALE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-836-9558",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MCO3019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.