Provider Demographics
NPI:1053825893
Name:INFINITE WELLNESS MEDICAL PC
Entity type:Organization
Organization Name:INFINITE WELLNESS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZE OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:UCHE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKWUBA
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:212-402-8097
Mailing Address - Street 1:14 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-1355
Mailing Address - Country:US
Mailing Address - Phone:212-402-8097
Mailing Address - Fax:212-407-8098
Practice Address - Street 1:20 E 46TH ST FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-9249
Practice Address - Country:US
Practice Address - Phone:212-402-8097
Practice Address - Fax:212-402-8098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111N00000X, 207N00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty