Provider Demographics
NPI:1902586712
Name:WELLBE NEW YORK MEDICAL PC
Entity Type:Organization
Organization Name:WELLBE NEW YORK MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-872-7559
Mailing Address - Street 1:225 W WASHINGTON ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-3404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 S CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1846
Practice Address - Country:US
Practice Address - Phone:855-443-3224
Practice Address - Fax:585-895-6246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty