| Total Mind Wellness Group | |
|
176 N Village Ave Ste 2g Rockville Centre NY 11570-3800 | |
| (516) 266-9110 | |
| (516) 200-2173 |
| Full Name | Total Mind Wellness Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 176 N Village Ave Ste 2g, Rockville Centre, New York |
| Authorized Official Name and Position | Daniel Moldwin (OWNER) |
| Authorized Official Contact | 5162669110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Mind Wellness Group 176 N Village Ave Ste 2g Rockville Centre NY 11570-3800 Ph: (516) 266-9110 | Total Mind Wellness Group 176 N Village Ave Ste 2g Rockville Centre NY 11570-3800 Ph: (516) 266-9110 |
| NPI Number | 1760152250 |
|---|---|
| Provider Enumeration Date | 09/15/2021 |
| Last Update Date | 05/17/2023 |
| Certification Date | 05/17/2023 |
| Medicare PECOS PAC ID | 5698152205 |
|---|---|
| Medicare Enrollment ID | O20220520001675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760152250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Daniel Moldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396351748 PECOS PAC ID: 7315324928 Enrollment ID: I20220520001779 |
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