| Wellness Health Medical Provider, P.c. | |
|
1 Laura Ln East Northport NY 11731-4700 | |
| (949) 325-7001 | |
| Not Available |
| Full Name | Wellness Health Medical Provider, P.c. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1 Laura Ln, East Northport, New York |
| Authorized Official Name and Position | Michael Boshardy (VP OF LEGAL) |
| Authorized Official Contact | 7738143028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Health Medical Provider, P.c. 17981 Sky Park Cir, Bldg 39, Ste Bc Irvine CA 92614-6309 Ph: (949) 325-7001 | Wellness Health Medical Provider, P.c. 1 Laura Ln East Northport NY 11731-4700 Ph: (949) 325-7001 |
| NPI Number | 1336856830 |
|---|---|
| Provider Enumeration Date | 11/03/2022 |
| Last Update Date | 11/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336856830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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