Provider Demographics
NPI:1063021244
Name:PINNACLE WELLNESS PC
Entity Type:Organization
Organization Name:PINNACLE WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUARNACCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-268-8383
Mailing Address - Street 1:193 US HIGHWAY 9 STE 2A
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3016
Mailing Address - Country:US
Mailing Address - Phone:718-268-8383
Mailing Address - Fax:
Practice Address - Street 1:193 US HIGHWAY 9 STE 2A
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3016
Practice Address - Country:US
Practice Address - Phone:718-268-8383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain