| Vip Wellness, Llc | |
|
727 Joralemon St Belleville NJ 07109-1455 | |
| (973) 751-2060 | |
| (973) 751-2291 |
| Full Name | Vip Wellness, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 727 Joralemon St, Belleville, New Jersey |
| Authorized Official Name and Position | Antonio Ciccone (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9737512060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vip Wellness, Llc Po Box 599 Roseland NJ 07068-0599 Ph: (973) 751-2060 | Vip Wellness, Llc 727 Joralemon St Belleville NJ 07109-1455 Ph: (973) 751-2060 |
| NPI Number | 1124580634 |
|---|---|
| Provider Enumeration Date | 04/03/2019 |
| Last Update Date | 04/03/2019 |
| Medicare PECOS PAC ID | 8921480849 |
|---|---|
| Medicare Enrollment ID | O20220809000998 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124580634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Antonio Ciccone |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1750413464 PECOS PAC ID: 5698704864 Enrollment ID: I20050808000888 |
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