Provider Demographics
NPI:1407426265
Name:WELLNEST
Entity Type:Organization
Organization Name:WELLNEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSARUMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:IGBINOSUN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:848-467-0383
Mailing Address - Street 1:1521 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-4035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:129 WASHINGTON ST STE 200
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4650
Practice Address - Country:US
Practice Address - Phone:848-467-0383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty