Provider Demographics
NPI:1639042526
Name:WELLMED NY LLC
Entity type:Organization
Organization Name:WELLMED NY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:VATELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-234-5532
Mailing Address - Street 1:2550 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5813
Mailing Address - Country:US
Mailing Address - Phone:855-505-2992
Mailing Address - Fax:855-505-2992
Practice Address - Street 1:2860 WEST 5TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224
Practice Address - Country:US
Practice Address - Phone:855-505-2992
Practice Address - Fax:855-505-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty