Provider Demographics
NPI:1447790274
Name:HOLISTIC MEDICAL WELLNESS, PLLC
Entity Type:Organization
Organization Name:HOLISTIC MEDICAL WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HILLEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TROPE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:646-239-1656
Mailing Address - Street 1:PO BOX 656
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-0666
Mailing Address - Country:US
Mailing Address - Phone:646-239-1656
Mailing Address - Fax:631-849-5824
Practice Address - Street 1:11 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-1589
Practice Address - Country:US
Practice Address - Phone:646-239-1656
Practice Address - Fax:631-849-5824
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DH MANAGEMENT GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230135207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty