Organization
WELLNESS CONSULTATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETSY ROCHELLE DUBOV REGISTERED DIETITIAN (PRESIDENT)
(732) 816-1651
Entity
Organization
Contact information
Practice address
8 OLD BRIDGE TPKE, SOUTH RIVER, NJ 08882-2400
(732) 390-4888
(732) 390-0255
Mailing address
6 ASPEN CT, EAST BRUNSWICK, NJ 08816-3345
(732) 816-1651
(732) 238-9509
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
00634638
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053650
MEDICARE PROVIDER NUMBER
NJ
Enumeration date
04/14/2009
Last updated
04/14/2009
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