The Keansburg Wellness Center Pe LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THE KEANSBURG WELLNESS CENTER PE LLC

Practice address

204 Main St
Keansburg, NJ 07734-1735

Phone

(732) 495-1474

Fax

(718) 679-9285

NPI assigned

Mar 6, 2026

Organization subpart

No

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

Authorized official

Name

Mrs. Denise Cammarata

Title

Credentialing

Phone

(646) 421-3566

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1772755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1710833348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 GIFFORDS LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082044",
            "telephone_number": "732-495-1474",
            "fax_number": "718-679-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MAIN ST",
            "city": "KEANSBURG",
            "state": "NJ",
            "postal_code": "077341735",
            "telephone_number": "732-495-1474",
            "fax_number": "718-679-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KEANSBURG WELLNESS CENTER PE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-06",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "CAMMARATA",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "646-421-3566",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Keansburg, NJ
• Providers in Keansburg, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.