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General NPI Number Information
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NPI Number | 1659933695
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Entity Type | Organization
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Legal Business Name | MEGA WELLNESS INC
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Dates
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Enumeration Date | 06/29/2019
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Last Update Date | 06/29/2019
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Provider Practice Location Address
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Address Line | 481 8TH AVE # 608
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City | NEW YORK
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State | NY
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Zip | 10001-1809
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Country | US
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Telephone | 917-775-3145
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Fax | 212-994-9737
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Provider Business Mailing Address
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Address Line | 2546 E 13TH ST APT A11
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City | BROOKLYN
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State | NY
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Zip | 11235-4306
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Country | US
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Telephone | 917-775-3145
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Fax | 212-994-9737
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANELINA GORDON
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Credential | DPT
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Telephone | 917-775-3145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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