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Organization

MEDWELL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MANOUCHEHR T SHAHAB MD (OWNER)
(201) 819-1081
Entity
Organization

Contact information

Practice address
33 CENTRAL AVE, MIDLAND PARK, NJ 07432
(201) 689-0800
(201) 689-0871
Mailing address
33 CENTRAL AVE, MIDLAND PARK, NJ 07432
(201) 689-0800
(201) 689-0871

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
208VP0000X
Pain Medicine Physician
225100000X
Physical Therapist
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Enumeration date
08/14/2006
Last updated
11/12/2008
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