Provider Demographics
NPI:1881864353
Name:ADVANCED WELLNESS CENTER OF ESSEX COUNTY, P.C.
Entity Type:Organization
Organization Name:ADVANCED WELLNESS CENTER OF ESSEX COUNTY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:ANZALONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-672-1870
Mailing Address - Street 1:81 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5342
Mailing Address - Country:US
Mailing Address - Phone:973-672-1870
Mailing Address - Fax:973-672-1871
Practice Address - Street 1:81 NORTHFIELD AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5342
Practice Address - Country:US
Practice Address - Phone:973-672-1870
Practice Address - Fax:973-672-1871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00535100111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty