Nu-Lyfe Wellness Center LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA01669100 Issued in NJ

Legal business name

NU-LYFE WELLNESS CENTER LLC

Practice address

279 Browertown Rd
Woodland Park, NJ 07424-2663

Phone

(973) 420-0030

NPI assigned

Oct 19, 2017

Organization subpart

No

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

Authorized official

Name

Kunal Pathak, PT

Title

Owner/ Physical Therapist

Phone

(973) 423-0030

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1902317738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 RIVERVIEW CT",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070944058",
            "telephone_number": "973-420-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 BROWERTOWN RD",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074242663",
            "telephone_number": "973-420-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NU-LYFE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-19",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "PATHAK",
        "authorized_official_first_name": "KUNAL",
        "authorized_official_title_or_position": "OWNER/ PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "973-423-0030",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01669100",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01669100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Woodland Park, NJ
• Providers in Woodland Park, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.