Provider Demographics
NPI:1144814476
Name:CARNELIAN WELLNESS, LLC
Entity type:Organization
Organization Name:CARNELIAN WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:WAJIDA
Authorized Official - Middle Name:AMINUDDIN
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:LAC MAC
Authorized Official - Phone:508-523-3061
Mailing Address - Street 1:743 CHAPEL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-1898
Mailing Address - Country:US
Mailing Address - Phone:508-523-3061
Mailing Address - Fax:
Practice Address - Street 1:222 W COLD SPRING LN STE B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2800
Practice Address - Country:US
Practice Address - Phone:443-961-1127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty