1437695236 NPI number — SYNERGY WEIGHT LOSS AND WELLNESS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437695236 NPI number — SYNERGY WEIGHT LOSS AND WELLNESS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SYNERGY WEIGHT LOSS AND WELLNESS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437695236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
186 PRINCETON HIGHTSTOWN RD
Provider Second Line Business Mailing Address:
BLDG. 3B, SUITE 104
Provider Business Mailing Address City Name:
WEST WINDSOR
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08550-1668
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-799-8444
Provider Business Mailing Address Fax Number:
609-799-6114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
186 PRINCETON HIGHTSTOWN RD
Provider Second Line Business Practice Location Address:
BLDG. 3B, SUITE 104
Provider Business Practice Location Address City Name:
WEST WINDSOR
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08550-1668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-799-8444
Provider Business Practice Location Address Fax Number:
609-799-6114
Provider Enumeration Date:
01/17/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SINGH
Authorized Official First Name:
ARUN
Authorized Official Middle Name:
JYOTI
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
609-799-8444

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)