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General NPI Number Information
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NPI Number | 1669125803
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Entity Type | Organization
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Legal Business Name | THE WELLNESS MEDICINE OF NEW YORK PC
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 6903 4TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-1509
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Country | US
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Telephone | 646-907-9072
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Fax |
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Provider Business Mailing Address
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Address Line | 66 MADISON AVE
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City | HASBROUCK HEIGHTS
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State | NJ
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Zip | 07604-1312
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Country | US
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Telephone | 646-907-9072
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Fax |
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Authorized Official
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Title or Position | MD
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Name | BECHOY ABDELMALAK
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Credential | MD
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Telephone | 917-291-7270
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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 |
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License Number State |
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