OrganizationActive
Diabetes Education and Wellness
NPI 1588053706 · Health Service Clinic/Center · Eatontown, NJ
Provider details
- NPI number
- 1588053706
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jenalyn Canullas, Program Coordinator(732) 500-1477
Specialties & taxonomies
Ambulatory Health Care Facilities
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1 Main St
Suite 226
Eatontown, NJ 07724-3450
Phone: (732) 500-1477
Approximate (ZIP-level) locationGet directions
Mailing address
352 Broad St
Eatontown, NJ 07724-1616
Registry dates
- Enumerated
- 2015-01-12
- Last updated
- 2015-02-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.