Healthcare Provider Details
I. General information
NPI: 1003736323
Provider Name (Legal Business Name): WHOLE COMPLETE HEALTH NP IN FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13740 LAURELTON PKWY
ROSEDALE NY
11422-1708
US
IV. Provider business mailing address
13740 LAURELTON PKWY
ROSEDALE NY
11422-1708
US
V. Phone/Fax
- Phone: 917-277-7601
- Fax: 917-970-9762
- Phone: 917-277-7601
- Fax: 917-970-9762
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
LEE
HYLTON
Title or Position: OWNER
Credential: NP
Phone: 917-277-7601