Provider Demographics
NPI:1417740291
Name:CARROLL HEALTH AND WELLNESS
Entity type:Organization
Organization Name:CARROLL HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:II
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:973-666-2319
Mailing Address - Street 1:6 KILMER RD STE 1118
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2432
Mailing Address - Country:US
Mailing Address - Phone:973-666-2319
Mailing Address - Fax:973-637-4441
Practice Address - Street 1:A53 WOODSIDE GDNS
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-1007
Practice Address - Country:US
Practice Address - Phone:973-666-2319
Practice Address - Fax:973-637-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care