Organization
TRISTATE MEDICAL AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANNETTE GONZALEZ SIMON DO (MEDICAL DIRECTOR)
(917) 294-4620
Entity
Organization
Contact information
Practice address
19 HATHAWAY LN, VERONA, NJ 07044-2306
(917) 294-4620
Mailing address
19 HATHAWAY LN, VERONA, NJ 07044-2306
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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