Organization
TRANSFORMATIVE HEALTH & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUNNY THAKKAR (MANAGING DIRECTOR)
(212) 227-3233
Entity
Organization
Contact information
Practice address
610 WASHINGTON BLVD, JERSEY CITY, NJ 07310-1400
(212) 227-3233
(866) 548-5687
Mailing address
610 WASHINGTON BLVD, JERSEY CITY, NJ 07310-1400
(212) 227-3233
(866) 548-5687
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA10802100
MEICAL LICENSE
NJ
Enumeration date
12/07/2020
Last updated
12/07/2020
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