| Wellcome Care Medical | |
|
2915 Far Rockaway Blvd Far Rockaway NY 11691-1941 | |
| (347) 230-4076 | |
| Not Available |
| Full Name | Wellcome Care Medical |
|---|---|
| Speciality | Pediatrics |
| Location | 2915 Far Rockaway Blvd, Far Rockaway, New York |
| Authorized Official Name and Position | Randi B Nelson (OWNER) |
| Authorized Official Contact | 3472304076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellcome Care Medical 2915 Far Rockaway Blvd Far Rockaway NY 11691-1941 Ph: (347) 230-4076 | Wellcome Care Medical 2915 Far Rockaway Blvd Far Rockaway NY 11691-1941 Ph: (347) 230-4076 |
| NPI Number | 1689424160 |
|---|---|
| Provider Enumeration Date | 03/26/2024 |
| Last Update Date | 07/26/2024 |
| Certification Date | 07/26/2024 |
| Medicare PECOS PAC ID | 2365883758 |
|---|---|
| Medicare Enrollment ID | O20240516001591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689424160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
| Provider Name | Randi B Nelson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215247895 PECOS PAC ID: 2860646197 Enrollment ID: I20160202002217 |
| Provider Name | Sonja R Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033630413 PECOS PAC ID: 8123390861 Enrollment ID: I20170816000306 |
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