Provider Demographics
NPI:1649880022
Name:MAPLEWOOD WELLNESS CENTER
Entity type:Organization
Organization Name:MAPLEWOOD WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NINGNING
Authorized Official - Middle Name:
Authorized Official - Last Name:HE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-723-6901
Mailing Address - Street 1:2040 MILLBURN AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3716
Mailing Address - Country:US
Mailing Address - Phone:973-379-3688
Mailing Address - Fax:
Practice Address - Street 1:2040 MILLBURN AVE STE 405
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3716
Practice Address - Country:US
Practice Address - Phone:973-379-3688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED PAIN CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty