Healthcare Provider Details

I. General information

NPI: 1124989579
Provider Name (Legal Business Name): NEW ORBIT WELLNESS NP IN ADULT HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 NEW ST APT 1D
HEWLETT NY
11557-2021
US

IV. Provider business mailing address

16 NEW ST APT 1D
HEWLETT NY
11557-2021
US

V. Phone/Fax

Practice location:
  • Phone: 718-529-0384
  • Fax:
Mailing address:
  • Phone: 718-529-0384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RENAE PACHECO
Title or Position: OWNER
Credential: NP
Phone: 718-529-0384