Healthcare Provider Details

I. General information

NPI: 1417295692
Provider Name (Legal Business Name): WELLNESS BEAUTYFARM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 02/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 W 32ND ST STE 1001
NEW YORK NY
10001-3880
US

IV. Provider business mailing address

38 W 32ND ST STE 1001
NEW YORK NY
10001-3880
US

V. Phone/Fax

Practice location:
  • Phone: 212-714-1004
  • Fax: 212-714-1009
Mailing address:
  • Phone: 212-714-1004
  • Fax: 212-714-1009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number031415
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004685
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number032405
License Number StateNY

VIII. Authorized Official

Name: MS. HEA YOON
Title or Position: PRESIDENT
Credential:
Phone: 212-714-1004