=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073010617
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RC WELLNESS MEDICAL PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2018
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8616 18TH AVE FL 1
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11214-3702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-868-5678
-----------------------------------------------------
Fax | 855-307-7998
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8616 18TH AVE FL 1
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11214-3702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-868-5678
-----------------------------------------------------
Fax | 855-307-7998
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RENEE CAI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 347-836-9898
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------