Provider Demographics
NPI:1750160644
Name:PLAZA WELLNESS & HEALTH CENTER LLC
Entity type:Organization
Organization Name:PLAZA WELLNESS & HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BASEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BATARSEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-797-2003
Mailing Address - Street 1:6-20 PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3113
Mailing Address - Country:US
Mailing Address - Phone:201-797-2003
Mailing Address - Fax:
Practice Address - Street 1:6-20 PLAZA RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3113
Practice Address - Country:US
Practice Address - Phone:201-509-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty