Functional Health PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

38MC00672100 Issued in NJ

Legal business name

FUNCTIONAL HEALTH PC

Practice address

32 Roosevelt Place
Somerville, NJ 08876

Phone

(908) 722-0500

NPI assigned

Jun 6, 2013

Organization subpart

No

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

Authorized official

Name

Christopher Wawrzyniak, D.CNPI 1679711584

Title

President

Phone

(908) 722-0500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

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

• Christopher Ross Wawrzyniak, D.C.

  • Chiropractor
  • Chatham, NJ
  • NPI 1679711584
  Medicare reassignment NPD Authorized official
• Frank E. Colabella, DPM, MS

  • Podiatrist
  • Fair Lawn, NJ
  • NPI 1023181195
  NPD (past)
• Romuald L Wawrzyniak, D.C

  • Chiropractor
  • Somerville, NJ
  • NPI 1811972748
  NPD (past)

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1467890970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 ROOSEVELT PLACE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "08876",
            "telephone_number": "908-722-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 ROOSEVELT PLACE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "08876",
            "telephone_number": "908-722-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "WAWRZYNIAK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-722-0500",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "38MC00672100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tova Friedman, LCSW
• Debra Schaffler Frisch, DPT
• Leslie Fry, PA
• Deborah Fugaro, AUD
• Laura Ashley Fuller-Polhamus, PSY.D
• Julie M Fuson, RDH
• April E Gadson
• Adam Galasso, DC
• Adelina Gallo, PHARMD
• Mirza Concepcion Gamboa

• Medical Specialty Clinic/Center in Somerville, NJ
• Providers in Somerville, NJ by specialty
• Medical Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.