MEDICARE: ULTIMATE HEALTH & WELLNESS PC

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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1831891134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE HEALTH & WELLNESS PC

Provider Business Mailing Address
First Line	:	224 NORTHFIELD RD
Second Line	:
City	:	HAUPPAUGE
State	:	NY
Zip	:	11788-2322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 BARROW ST
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-3578
Country	:	US
Telephone Number	:	201-433-2096
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BILLY FORD
Credential	:	MD
Telephone Number	:	914-376-6100

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	03/20/2023

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