Jersey Wellness Associates LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00001000 Issued in NJ

Legal business name

JERSEY WELLNESS ASSOCIATES LLC

Practice address

2306 New Rd
Northfield, NJ 08225-1407

Phone

(609) 513-1387

NPI assigned

Oct 15, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Leonard Staller, P.A.

Title

Owner

Phone

(609) 513-1387

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1619229671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 N 5TH AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042953",
            "telephone_number": "609-513-1387",
            "fax_number": "609-463-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 NEW RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251407",
            "telephone_number": "609-513-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY WELLNESS ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "STALLER",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-513-1387",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.A."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00001000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daud Jamil, MA, LPC
• Yashika Jani, APN
• Jay H. Schwartz, MD, LLC
• Paul Jennings, LPC
• Jersey Shore Physical Therapy and Rehab
• Maria Jose Jimenez Cerna, M.D.
• John D. Lorenzetti, M.D.,F.a.C.S.,Inc.
• John McLernon Mental Health Services LLC
• Chelsey Johnson, MSW, LSW
• Deborah Joseph, PMHNP-BC

• Physician Assistant in Northfield, NJ
• Providers in Northfield, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.