Provider Demographics
NPI:1851443048
Name:PHYSICIANS WELLNESS CENTER
Entity Type:Organization
Organization Name:PHYSICIANS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HITESH
Authorized Official - Middle Name:RAMESH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-744-0634
Mailing Address - Street 1:1804 OAK TREE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2704
Mailing Address - Country:US
Mailing Address - Phone:732-744-0634
Mailing Address - Fax:732-744-0635
Practice Address - Street 1:1804 OAK TREE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2704
Practice Address - Country:US
Practice Address - Phone:732-744-0634
Practice Address - Fax:732-744-0635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA69747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty