Provider Demographics
NPI:1699006080
Name:WELLINGTON MEDICAL LLC
Entity Type:Organization
Organization Name:WELLINGTON MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:PAGANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-621-0007
Mailing Address - Street 1:111 WELLINGTON PL
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-1758
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 WELLINGTON PL
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1758
Practice Address - Country:US
Practice Address - Phone:513-621-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty