Provider Demographics
NPI:1902565211
Name:WELLNESS NP IN COMMUNITY HEALTH P.C.
Entity Type:Organization
Organization Name:WELLNESS NP IN COMMUNITY HEALTH P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-413-2734
Mailing Address - Street 1:3215 AVENUE H BROOKLYN, NY 11210
Mailing Address - Street 2:SUITE 1P
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210
Mailing Address - Country:US
Mailing Address - Phone:718-717-2278
Mailing Address - Fax:
Practice Address - Street 1:3215 AVENUE H BROOKLYN, NY 11210
Practice Address - Street 2:SUITE 1P
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210
Practice Address - Country:US
Practice Address - Phone:718-717-2278
Practice Address - Fax:929-234-6504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty