Organization
KEY TO WELLNESS PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILIS PASKO (CREDENTIALING ASSOCIATE)
(201) 500-6992
Entity
Organization
Contact information
Practice address
170 LINCOLN ST, ENGLEWOOD, NJ 07631-3118
(201) 500-6992
(833) 605-4359
Mailing address
170 LINCOLN ST, ENGLEWOOD, NJ 07631-3118
(201) 500-6992
(833) 605-4359
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004999
—
NJ
Enumeration date
04/28/2025
Last updated
06/06/2025
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