Provider Demographics
NPI:1447403845
Name:ATLANTO HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:ATLANTO HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SPROVIERO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-951-7446
Mailing Address - Street 1:226 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-1473
Mailing Address - Country:US
Mailing Address - Phone:973-574-9380
Mailing Address - Fax:973-573-9383
Practice Address - Street 1:335 PASSAIC ST
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5818
Practice Address - Country:US
Practice Address - Phone:973-358-5500
Practice Address - Fax:973-358-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00502200320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ083480Medicare UPIN