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THE KEANSBURG WELLNESS CENTER PE LLC
NPI 1710833348
Internal Medicine in Keansburg, NJ

Active since March 06, 2026CLIA 31D2345522 · Waiver
204 MAIN ST, KEANSBURG, NJ 07734(732) 495-1474(718) 679-9285 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 11, 2026, Mar 6, 2026 (2 updates tracked since 2026).

About The Keansburg Wellness Center Pe Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE KEANSBURG WELLNESS CENTER PE LLC (NPI 1710833348) is a healthcare organization registered as an internal medicine in Keansburg, New Jersey and active in the NPI registry since March 2026. The organization holds a CLIA Waiver certificate valid through June 10, 2028 and lists Denise Cammarata, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1710833348
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameTHE KEANSBURG WELLNESS CENTER PE LLC
Location Address204 MAIN STKeansburg, NJ 07734-1735
Mailing Address233 Giffords LnStaten Island, NY 10308-2044 · (732) 495-1474 · Fax (718) 679-9285
Phone(732) 495-1474
Fax(718) 679-9285
Organization SubpartNo
Authorized OfficialDenise CammarataCredentialing · (646) 421-3566
Enumeration DateMarch 6, 2026
Last NPPES UpdateMarch 11, 20262 updates tracked since enumeration
NPPES CertifiedMarch 11, 2026
✔ NPI 1710833348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
204 MAIN ST, Keansburg, NJ 07734
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2345522

The Keansburg Wellness Center Pe, LLC · Keansburg, NJ
Active · expires Jun 10, 2028
CLIA Number31D2345522
Laboratory TypePhysician Office
Certificate Effective DateJune 11, 2026
Certificate Expiration DateJune 10, 2028
Laboratory DirectorLionel Anicette Jr
Laboratory Phone(732) 471-6096
Laboratory LocationThe Keansburg Wellness Center Pe, LLC204 Main St, Keansburg, NJ 07734
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEANSBURG WELLNESS CENTER LLC
Clinic/Center (Multi-Specialty)
204 MAIN ST
KEANSBURG, NJ 07734
Monmouth County (732) 495-1474

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Keansburg Wellness Center Pe LLC's NPI number?

The NPI number for The Keansburg Wellness Center Pe LLC is 1710833348. It was assigned to this organization in the NPPES registry on March 6, 2026.

Where is The Keansburg Wellness Center Pe LLC located?

The Keansburg Wellness Center Pe LLC is located at 204 Main St, Keansburg, NJ 07734. The listed phone number is (732) 495-1474.

What is The Keansburg Wellness Center Pe LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does The Keansburg Wellness Center Pe LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2345522) is associated with this NPI, valid through June 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for The Keansburg Wellness Center Pe LLC was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.