Provider Demographics
NPI:1851676548
Name:NORTH JERSEY WHOLE HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:NORTH JERSEY WHOLE HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PRESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-569-1444
Mailing Address - Street 1:546 BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-5011
Mailing Address - Country:US
Mailing Address - Phone:201-569-1444
Mailing Address - Fax:201-569-1445
Practice Address - Street 1:546 BROAD AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-5011
Practice Address - Country:US
Practice Address - Phone:201-569-1444
Practice Address - Fax:201-569-1445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00695500261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center