Provider Demographics
NPI:1811798804
Name:OPTIMIZED WELLNESS, INC
Entity type:Organization
Organization Name:OPTIMIZED WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF TRUSTEE
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-939-0839
Mailing Address - Street 1:140 BAY ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-5909
Mailing Address - Country:US
Mailing Address - Phone:201-533-9883
Mailing Address - Fax:201-633-2771
Practice Address - Street 1:140 BAY ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-5909
Practice Address - Country:US
Practice Address - Phone:201-533-9883
Practice Address - Fax:201-633-2771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)