# JERSEY WELLNESS ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619229671
- **Authorized official:** MR. LEONARD STALLER P.A. (OWNER)
- **Authorized official phone:** (609) 513-1387

## Contact information

- **Practice address:** 2306 NEW RD, NORTHFIELD, NJ 08225-1407
- **Practice address phone:** (609) 513-1387
- **Mailing address:** 296 N 5TH AVE, HIGHLAND PARK, NJ 08904-2953
- **Mailing address phone:** (609) 513-1387
- **Mailing address fax:** (609) 463-8106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 25MP00001000 | NJ | Yes |

## Other

- **Enumeration date:** 10/15/2012
- **Last updated:** 12/18/2012