Organization
GENESIS WELLNESS MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED R TAWADROUS (MD/MEDICAL DIRECTOR)
(347) 677-3022
Entity
Organization
Contact information
Practice address
1544 KUSER RD STE C1, HAMILTON, NJ 08619-3830
(609) 585-3640
(609) 585-3620
Mailing address
1544 KUSER RD STE C1, HAMILTON, NJ 08619-3830
(609) 585-3640
(609) 585-3620
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0447366
—
NJ
Enumeration date
05/27/2019
Last updated
04/06/2020
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