Basic Information
| Provider Information | |||||||||
| NPI: | 1508280322 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PATHWAYS TO WELLNESS LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CENTER FOR WELLNESS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43 LINWOOD DR | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088313788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092458550 | ||||||||
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| Practice Location | |||||||||
| Address1: | 312 APPLEGARTH RD | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088315347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326554239 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2014 | ||||||||
| LastUpdateDate: | 02/13/2014 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SINGH | ||||||||
| AuthorizedOfficialFirstName: | GAGANDEEP | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9086756010 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0855X | N | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | 261QM0850X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.