Provider Demographics
NPI:1275735466
Name:WELLNESS MEDICAL CARE PC
Entity Type:Organization
Organization Name:WELLNESS MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-667-4399
Mailing Address - Street 1:22 W 1ST STREET
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550
Mailing Address - Country:US
Mailing Address - Phone:914-667-4399
Mailing Address - Fax:914-667-4471
Practice Address - Street 1:22 W. 1ST STREET
Practice Address - Street 2:SUITE 208
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-667-4399
Practice Address - Fax:914-667-4471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011085-1111N00000X
NY175176-1225100000X
NY261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01399757Medicaid
NY01399757Medicaid