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General NPI Number Information
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NPI Number | 1871164228
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Entity Type | Organization
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Legal Business Name | HEALTH WISE MEDICAL PC
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Dates
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Enumeration Date | 07/07/2021
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 5955 47TH AVE
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City | WOODSIDE
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State | NY
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Zip | 11377-5668
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Country | US
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Telephone | 516-962-4384
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Fax |
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Provider Business Mailing Address
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Address Line | 43 SCHOOLHOUSE LN
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-2819
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | THULASI R REDDY
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Credential |
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Telephone | 347-228-4383
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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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