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NPI Code Detail

MEDICARE: WELL WELLNESS MEDICAL PLLC

MEDICARE: WELL WELLNESS MEDICAL PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1114620531
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELL WELLNESS MEDICAL PLLC
Provider Business Mailing Address
First Line : 837 59TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-5576
Country : US
Telephone Number : 718-680-8881
Fax Number : 718-680-7880
Provider Business Practice Location Address
First Line : 837 59TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-5576
Country : US
Telephone Number : 718-680-8881
Fax Number : 718-680-7880
Authorized Official
Title or Position : MD
Name : YONG KANG HE
Credential :
Telephone Number : 718-680-8881
Provider Enumeration Date : 03/24/2023
Last Update Date : 03/24/2023

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Directions to “WELL WELLNESS MEDICAL PLLC ” Practice Location

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