Provider Demographics
NPI:1972111276
Name:KEARNY WELLNESS
Entity Type:Organization
Organization Name:KEARNY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-565-3995
Mailing Address - Street 1:841 KEARNY AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-3249
Mailing Address - Country:US
Mailing Address - Phone:201-565-3995
Mailing Address - Fax:732-851-1304
Practice Address - Street 1:841 KEARNY AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3249
Practice Address - Country:US
Practice Address - Phone:201-565-3995
Practice Address - Fax:732-851-1304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty