Provider Demographics
NPI:1659164697
Name:SILVER WILLOW WELLNESS PC
Entity type:Organization
Organization Name:SILVER WILLOW WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:WADHWANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-901-2493
Mailing Address - Street 1:2395 LANCASTER PIKE FL 1
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2375
Mailing Address - Country:US
Mailing Address - Phone:585-233-2817
Mailing Address - Fax:833-411-5741
Practice Address - Street 1:2395 LANCASTER PIKE FL 1
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-2375
Practice Address - Country:US
Practice Address - Phone:585-233-2817
Practice Address - Fax:833-411-5741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-23
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty