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General NPI Number Information
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NPI Number | 1518744879
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Entity Type | Organization
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Legal Business Name | THE WELLNESS CARE NP IN FAMILY HEALTH PC
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 31 E 32ND ST RM 610
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City | NEW YORK
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State | NY
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Zip | 10016-5592
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Country | US
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Telephone | 347-426-7513
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Fax |
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Provider Business Mailing Address
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Address Line | 701 W 177TH ST APT 43
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City | NEW YORK
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State | NY
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Zip | 10033-6909
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Country | US
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Telephone | 347-426-7513
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KAB JU KIM-AMARO
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Credential | NP
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Telephone | 347-426-7513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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