Provider Demographics
NPI:1518855741
Name:PRO-HEALTH AND WELLNESS LLC.
Entity type:Organization
Organization Name:PRO-HEALTH AND WELLNESS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-BC OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:914-705-1207
Mailing Address - Street 1:39 QUARRY DR
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-3032
Mailing Address - Country:US
Mailing Address - Phone:914-705-1207
Mailing Address - Fax:
Practice Address - Street 1:39 QUARRY DR
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-3032
Practice Address - Country:US
Practice Address - Phone:914-705-1207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty