Provider Demographics
NPI:1316533763
Name:JERSEY GIRL HEALTH AND WEALTH LLC
Entity type:Organization
Organization Name:JERSEY GIRL HEALTH AND WEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-772-3870
Mailing Address - Street 1:136 WILCOX CT
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3564
Mailing Address - Country:US
Mailing Address - Phone:914-772-3870
Mailing Address - Fax:
Practice Address - Street 1:479 ROUTE 79
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-4061
Practice Address - Country:US
Practice Address - Phone:914-772-3870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty