Provider Demographics
NPI:1154745123
Name:MAXIMUM HEALTH & WELLNESS KENILWORTH LLC
Entity type:Organization
Organization Name:MAXIMUM HEALTH & WELLNESS KENILWORTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE REP
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-789-3227
Mailing Address - Street 1:505 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07033-1076
Mailing Address - Country:US
Mailing Address - Phone:973-585-7315
Mailing Address - Fax:
Practice Address - Street 1:505 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07033-1076
Practice Address - Country:US
Practice Address - Phone:973-585-7315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty