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NPI Code Detail

MEDICARE: WELLCOME CARE MEDICAL

MEDICARE: WELLCOME CARE MEDICAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker
2207Q00000XFamily Medicine Physician
3208000000XPediatrics Physician

General Provider Information

NPI Number : 1689424160
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELLCOME CARE MEDICAL
Provider Business Mailing Address
First Line : 2915 FAR ROCKAWAY BLVD
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-1941
Country : US
Telephone Number : 347-230-4076
Fax Number :
Provider Business Practice Location Address
First Line : 2915 FAR ROCKAWAY BLVD
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-1941
Country : US
Telephone Number : 347-230-4076
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RANDI B NELSON
Credential : MD
Telephone Number : 347-230-4076
Provider Enumeration Date : 03/26/2024
Last Update Date : 07/26/2024

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Directions to “WELLCOME CARE MEDICAL ” Practice Location

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