Provider Demographics
NPI:1871364851
Name:HEALTH AND WELLNESS BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:HEALTH AND WELLNESS BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/APN
Authorized Official - Prefix:
Authorized Official - First Name:OSAGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-957-1119
Mailing Address - Street 1:236 CLAIRMONT TER
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-3144
Mailing Address - Country:US
Mailing Address - Phone:201-957-1119
Mailing Address - Fax:
Practice Address - Street 1:134 EVERGREEN PL STE 503
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2010
Practice Address - Country:US
Practice Address - Phone:201-957-1119
Practice Address - Fax:201-367-2438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty