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General NPI Number Information
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NPI Number | 1326138678
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR EMOTIONAL WELLNESS
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Dates
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Enumeration Date | 10/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4045 POSTAL DR
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City | ROANOKE
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State | VA
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Zip | 24018-6439
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Country | US
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Telephone | 540-776-0175
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Fax | 540-776-0488
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Provider Business Mailing Address
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Address Line | 4045 POSTAL DR
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City | ROANOKE
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State | VA
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Zip | 24018-6439
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Country | US
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Telephone | 540-776-0175
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Fax | 540-776-0488
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Authorized Official
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Title or Position | OFFICER/OWNER
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Name | DR. NICHOLAS A ZELTVAY
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Credential | D.O.
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Telephone | 540-776-0175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0102037090
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License Number State | VA
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