Provider Demographics
NPI:1356051163
Name:WELLVIEW MEDICAL PC
Entity type:Organization
Organization Name:WELLVIEW MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EDELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-924-6263
Mailing Address - Street 1:200 WHITE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1162
Mailing Address - Country:US
Mailing Address - Phone:732-924-6263
Mailing Address - Fax:432-200-0185
Practice Address - Street 1:200 WHITE RD STE 203
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1162
Practice Address - Country:US
Practice Address - Phone:732-924-6263
Practice Address - Fax:432-200-0185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty