Provider Demographics
NPI:1467746222
Name:COMPLETE WELLNESS MEDICAL CARE PC
Entity Type:Organization
Organization Name:COMPLETE WELLNESS MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YUE
Authorized Official - Middle Name:HE
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-618-7612
Mailing Address - Street 1:471 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-4401
Mailing Address - Country:US
Mailing Address - Phone:718-618-7612
Mailing Address - Fax:718-618-7617
Practice Address - Street 1:471 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4401
Practice Address - Country:US
Practice Address - Phone:718-618-7612
Practice Address - Fax:718-618-7617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty