Provider Demographics
NPI:1114461704
Name:WENGS GROUP NY INC
Entity Type:Organization
Organization Name:WENGS GROUP NY INC
Other - Org Name:ADJ WISDOM HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:XIU
Authorized Official - Middle Name:MEI
Authorized Official - Last Name:WENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-226-8218
Mailing Address - Street 1:230 GRAND ST
Mailing Address - Street 2:SUITE 2M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4241
Mailing Address - Country:US
Mailing Address - Phone:212-226-8218
Mailing Address - Fax:212-226-8221
Practice Address - Street 1:230 GRAND ST
Practice Address - Street 2:SUITE 2M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4241
Practice Address - Country:US
Practice Address - Phone:212-226-8218
Practice Address - Fax:212-226-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2250L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2250L001OtherNYSDOH LICENSE