Provider Demographics
NPI:1154097244
Name:NATURAL WELLNESS MEDICINE PLLC
Entity Type:Organization
Organization Name:NATURAL WELLNESS MEDICINE PLLC
Other - Org Name:TRIGGER POINT MEDICAL WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-506-8907
Mailing Address - Street 1:118 GLEN COVE RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1718
Mailing Address - Country:US
Mailing Address - Phone:631-506-8907
Mailing Address - Fax:
Practice Address - Street 1:71 E MAIN ST
Practice Address - Street 2:
Practice Address - City:KINGS PARK
Practice Address - State:NY
Practice Address - Zip Code:11754-2709
Practice Address - Country:US
Practice Address - Phone:631-225-2623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty