Healthcare Provider Details

I. General information

NPI: 1568366243
Provider Name (Legal Business Name): WELLBRIDGE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SHERWOOD AVE # 202
SPRING VALLEY NY
10977-5406
US

IV. Provider business mailing address

7 SHERWOOD AVE # 202
SPRING VALLEY NY
10977-5406
US

V. Phone/Fax

Practice location:
  • Phone: 845-520-0579
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MORDECHAI KLEIN
Title or Position: COO
Credential:
Phone: 438-622-0579