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Organization
MEDWELL LLC
Active
Organization
MEDWELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANOUCHEHR T SHAHAB MD (OWNER)
(201) 819-1081
Entity
Organization
Contact information
Practice address
33 CENTRAL AVE, MIDLAND PARK, NJ 07432
(201) 689-0800
(201) 689-0871
Mailing address
33 CENTRAL AVE, MIDLAND PARK, NJ 07432
(201) 689-0800
(201) 689-0871
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
08/14/2006
Last updated
11/12/2008
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