Provider Demographics
NPI:1285005884
Name:NORTH JERSEY HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:NORTH JERSEY HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:BERBERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-819-8545
Mailing Address - Street 1:227 DONNY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1422
Mailing Address - Country:US
Mailing Address - Phone:201-819-8545
Mailing Address - Fax:805-473-5931
Practice Address - Street 1:227 DONNY BROOK DR
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-1422
Practice Address - Country:US
Practice Address - Phone:201-819-8545
Practice Address - Fax:805-473-5931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
NJ25MA09655600261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty