Provider Demographics
NPI:1104572361
Name:HEALTH AND WILLNESS LLC
Entity type:Organization
Organization Name:HEALTH AND WILLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:732-708-6501
Mailing Address - Street 1:70 JOYCE KILMER AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-8045
Mailing Address - Country:US
Mailing Address - Phone:732-708-6501
Mailing Address - Fax:732-605-5763
Practice Address - Street 1:70 JOYCE KILMER AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-8045
Practice Address - Country:US
Practice Address - Phone:732-708-6501
Practice Address - Fax:732-605-5763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty