Organization
NU-LYFE WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KUNAL PATHAK PT (OWNER/ PHYSICAL THERAPIST)
(973) 423-0030
Entity
Organization
Contact information
Practice address
279 BROWERTOWN RD, WOODLAND PARK, NJ 07424-2663
(973) 420-0030
Mailing address
68 RIVERVIEW CT, SECAUCUS, NJ 07094-4058
(973) 420-0030
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NJ
171100000X
Acupuncturist
—
NJ
225100000X
Physical Therapist
40QA01669100
NJ
261QP2000X
Physical Therapy Clinic/Center
Primary
40QA01669100
NJ
Other
Enumeration date
10/19/2017
Last updated
02/07/2020
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