Provider Demographics
NPI:1154760841
Name:DO WELL BE WELL OF HASKELL
Entity type:Organization
Organization Name:DO WELL BE WELL OF HASKELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-831-2880
Mailing Address - Street 1:1141 RINGWOOD AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HASKELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07420-1565
Mailing Address - Country:US
Mailing Address - Phone:973-831-2880
Mailing Address - Fax:862-248-0528
Practice Address - Street 1:1141 RINGWOOD AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:HASKELL
Practice Address - State:NJ
Practice Address - Zip Code:07420-1565
Practice Address - Country:US
Practice Address - Phone:973-831-2880
Practice Address - Fax:862-248-0528
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DO WELL BE WELL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty