Provider Demographics
NPI:1134703648
Name:WELL PRIMARY CARE SERVICES
Entity Type:Organization
Organization Name:WELL PRIMARY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOFFOLI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APN-C
Authorized Official - Phone:609-374-4178
Mailing Address - Street 1:1495 PAUL BLVD
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-4136
Mailing Address - Country:US
Mailing Address - Phone:609-374-4178
Mailing Address - Fax:
Practice Address - Street 1:853 MILL CREEK RD
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-0805
Practice Address - Country:US
Practice Address - Phone:609-374-4178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty