Provider Demographics
NPI:1184668493
Name:COMMUNITY FAMILY HEALTH AND WELLNESS CENTER INC.
Entity Type:Organization
Organization Name:COMMUNITY FAMILY HEALTH AND WELLNESS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRATERY
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:CAMPANELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-831-6700
Mailing Address - Street 1:909 RINGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07420-1343
Mailing Address - Country:US
Mailing Address - Phone:973-831-6700
Mailing Address - Fax:973-831-6703
Practice Address - Street 1:909 RINGWOOD AVE
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:NJ
Practice Address - Zip Code:07420-1343
Practice Address - Country:US
Practice Address - Phone:973-831-6700
Practice Address - Fax:973-831-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00076500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty