Organization
JERSEY WELLNESS ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEONARD STALLER P.A. (OWNER)
(609) 513-1387
Entity
Organization
Contact information
Practice address
2306 NEW RD, NORTHFIELD, NJ 08225-1407
(609) 513-1387
Mailing address
296 N 5TH AVE, HIGHLAND PARK, NJ 08904-2953
(609) 513-1387
(609) 463-8106
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00001000
NJ
Other
Enumeration date
10/15/2012
Last updated
12/18/2012
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