Organization
CHAVIV TRT & WELLNESS CLINIC LLC
Active
Organization
CHAVIV TRT & WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN OWUSU-MENSAH DNP, PMHNP, APN (NURSE PRACTITIONER)
(973) 902-8484
Entity
Organization
Contact information
Practice address
750 ROUTE 73 S STE 205, MARLTON, NJ 08053-4133
(609) 507-1939
Mailing address
44 BERNARD DR, EWING, NJ 08628-2301
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
08/21/2025
Last updated
08/21/2026
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