Healthcare Provider Details

I. General information

NPI: 1194642744
Provider Name (Legal Business Name): CHESTNUT RIDGE WELLNESS MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 DEMAREST RD
CHESTNUT RIDGE NY
10977-6517
US

IV. Provider business mailing address

7 DEMAREST RD
CHESTNUT RIDGE NY
10977-6517
US

V. Phone/Fax

Practice location:
  • Phone: 845-222-8462
  • Fax: 949-909-8123
Mailing address:
  • Phone: 845-222-8462
  • Fax: 949-909-8123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NICOLE FALANGA
Title or Position: AUTHORIZED OFFICIAL/ OWNER
Credential: MD
Phone: 845-222-8462