Healthcare Provider Details

I. General information

NPI: 1063381747
Provider Name (Legal Business Name): HEALTH WELLNESS MEDICAL ASTORIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3274 STEINWAY ST
ASTORIA NY
11103-4006
US

IV. Provider business mailing address

3274 STEINWAY ST
ASTORIA NY
11103-4006
US

V. Phone/Fax

Practice location:
  • Phone: 347-354-1328
  • Fax: 332-296-8382
Mailing address:
  • Phone: 347-354-1328
  • Fax: 332-296-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. OLUTIMILEHIN OYENIRAN
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 908-344-8963