Provider Demographics
NPI:1811046030
Name:WELLS, LINDA DIMAURO (DC DOCTOR OF CHIROPR)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:DIMAURO
Last Name:WELLS
Suffix:
Gender:F
Credentials:DC DOCTOR OF CHIROPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 PARK AVENUE
Mailing Address - Street 2:LINDA DIMAURO WELLS DC
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-2405
Mailing Address - Country:US
Mailing Address - Phone:201-307-0557
Mailing Address - Fax:201-307-0814
Practice Address - Street 1:251 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656-2405
Practice Address - Country:US
Practice Address - Phone:201-307-0557
Practice Address - Fax:201-307-0814
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00205600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
203881OtherHEALTH NET
0021394OtherGHI
P631923OtherOXFORD
P631923OtherOXFORD