Healthcare Provider Details
I. General information
NPI: 1770116956
Provider Name (Legal Business Name): WELLBEING MEDICAL CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/17/2020
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3745 75TH STREET
JACKSON HEIGHTS NY
11372-6435
US
IV. Provider business mailing address
PO BOX 506
PLAINVIEW NY
11803-7000
US
V. Phone/Fax
- Phone: 347-813-4502
- Fax: 844-896-0187
- Phone: 516-668-9875
- Fax: 844-896-0187
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NUVEED
LOQMAN
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 516-668-9875