Provider Demographics
NPI:1629588306
Name:EPIWELL, LLC
Entity Type:Organization
Organization Name:EPIWELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER-CEO/ PI
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGNOLIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIZA-NIETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-229-2780
Mailing Address - Street 1:108 ASTER LN APT 215
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1372
Mailing Address - Country:US
Mailing Address - Phone:607-229-2780
Mailing Address - Fax:
Practice Address - Street 1:108 ASTER LN APT 215
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1372
Practice Address - Country:US
Practice Address - Phone:607-229-2780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Single Specialty