Provider Demographics
NPI:1942987508
Name:ESSEX COUNTY HEALTH AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:ESSEX COUNTY HEALTH AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZICKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:917-612-4511
Mailing Address - Street 1:185 CENTRAL AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-3318
Mailing Address - Country:US
Mailing Address - Phone:862-520-1920
Mailing Address - Fax:
Practice Address - Street 1:185 CENTRAL AVE STE 311
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-3318
Practice Address - Country:US
Practice Address - Phone:862-520-1920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty