Healthcare Provider Details

I. General information

NPI: 1124799903
Provider Name (Legal Business Name): WINIXX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 E 57TH ST FL 14
NEW YORK NY
10022-2050
US

IV. Provider business mailing address

99 WALL ST # 1025
NEW YORK NY
10005-4301
US

V. Phone/Fax

Practice location:
  • Phone: 917-535-6928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. MEDDY EYAKOLA
Title or Position: CEO
Credential:
Phone: 917-535-6928