Provider Demographics
NPI:1477060382
Name:SILVER SPRING WELLNESS INC
Entity Type:Organization
Organization Name:SILVER SPRING WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SABBATH
Authorized Official - Middle Name:LARI
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:347-306-1014
Mailing Address - Street 1:35 W 31ST ST RM 1103
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4418
Mailing Address - Country:US
Mailing Address - Phone:347-306-1014
Mailing Address - Fax:
Practice Address - Street 1:35 W 31ST ST RM 1103
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4418
Practice Address - Country:US
Practice Address - Phone:347-306-1014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003537171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty