# MOBILE MEDICAL WELLNESS LLC

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

## Provider details

- **NPI number:** 1972081909
- **Authorized official:** MELISSA NIELI (CREDENTIALING MANAGER)
- **Authorized official phone:** (914) 376-6100

## Contact information

- **Practice address:** 851 FRANKLIN LAKE RD STE 33, FRANKLIN LAKES, NJ 07417-2266
- **Practice address phone:** (914) 376-6100
- **Practice address fax:** (914) 470-5056
- **Mailing address:** 851 FRANKLIN LAKE RD STE 33, FRANKLIN LAKES, NJ 07417-2266
- **Mailing address phone:** (914) 376-6100
- **Mailing address fax:** (914) 470-5056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/01/2018
- **Last updated:** 08/01/2018