Provider Demographics
NPI:1841911559
Name:SPOTSWOOD WELLNESS CENTER LLC
Entity type:Organization
Organization Name:SPOTSWOOD WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED-AMR
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:908-616-2889
Mailing Address - Street 1:14 SNOWHILL ST
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-1358
Mailing Address - Country:US
Mailing Address - Phone:732-955-6060
Mailing Address - Fax:732-210-4821
Practice Address - Street 1:14 SNOWHILL ST
Practice Address - Street 2:
Practice Address - City:SPOTSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08884-1358
Practice Address - Country:US
Practice Address - Phone:732-955-6060
Practice Address - Fax:732-210-4821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-09
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty