Organization
JERSEY SHORE MENTAL WELLNESS LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE MARIE IANNACONE APN (OWNER)
(609) 713-5540
Entity
Organization
Contact information
Practice address
2640 HIGHWAY 70 STE 10, MANASQUAN, NJ 08736-2612
(732) 612-3188
Mailing address
2640 HIGHWAY 70 STE 10, MANASQUAN, NJ 08736-2612
(732) 612-3188
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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