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General NPI Number Information
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NPI Number | 1205636289
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Entity Type | Organization
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Legal Business Name | WELLNESS PHYSICAL MEDICINE & REHABILITATION PC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 18016 WEXFORD TER STE CB
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City | JAMAICA
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State | NY
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Zip | 11432-3004
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Country | US
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Telephone | 718-658-5639
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Fax | 718-657-5607
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Provider Business Mailing Address
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Address Line | 18016 WEXFORD TER STE CB
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City | JAMAICA
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State | NY
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Zip | 11432-3004
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Country | US
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Telephone | 718-658-5639
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Fax | 718-657-5607
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. HASAN CHUGHTAI
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Credential | DO
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Telephone | 718-658-5639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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