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NPI Code Detail

MEDICARE: STELLAR WELLNESS CENTER INC.

MEDICARE: STELLAR WELLNESS CENTER INC.
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
1225100000XPhysical TherapistNY

General Provider Information

NPI Number : 1851633309
Entity Type Code : Organization
Provider Name (Legal Business Name) : STELLAR WELLNESS CENTER INC.
Provider Business Mailing Address
First Line : 2546 E 13TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-4358
Country : US
Telephone Number : 347-673-8729
Fax Number : 347-673-8974
Provider Business Practice Location Address
First Line : 3001 BRIGHTON 1ST ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-8008
Country : US
Telephone Number : 347-673-8729
Fax Number : 347-673-8974
Authorized Official
Title or Position : OWNER
Name : ANGELINA GORDON
Credential : DPT
Telephone Number : 917-775-3145
Provider Enumeration Date : 03/22/2013
Last Update Date : 08/05/2013

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Directions to “STELLAR WELLNESS CENTER INC. ” Practice Location

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