Provider Demographics
NPI:1962244855
Name:CONNECT HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:CONNECT HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:PTA, LMT
Authorized Official - Phone:201-608-3124
Mailing Address - Street 1:5711 JEFFERSON ST APT 210
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1118
Mailing Address - Country:US
Mailing Address - Phone:201-275-3079
Mailing Address - Fax:
Practice Address - Street 1:2002 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-4431
Practice Address - Country:US
Practice Address - Phone:201-608-3124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty