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General NPI Number Information
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NPI Number | 1528885613
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Entity Type | Organization
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Legal Business Name | WELLBEING CLINIC PC
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Dates
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Enumeration Date | 09/20/2024
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 4332 22ND ST STE 203
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-5077
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Country | US
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Telephone | 551-395-7952
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Fax | 620-877-9147
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Provider Business Mailing Address
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Address Line | 466 HACKENSACK AVE # 1043
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City | HACKENSACK
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State | NJ
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Zip | 07601-6305
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Country | US
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Telephone | 551-395-7952
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Fax | 620-877-9147
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Authorized Official
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Title or Position | CHIEF COUNCILLOR
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Name | MIOK IM
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Credential | APRN, FNP-C, PMHNP-B
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Telephone | 551-395-7952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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