Provider Demographics
NPI:1750035879
Name:WELL-AMERICA CORP
Entity Type:Organization
Organization Name:WELL-AMERICA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YASIR
Authorized Official - Middle Name:J
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-248-0777
Mailing Address - Street 1:79 OGLE RD
Mailing Address - Street 2:
Mailing Address - City:OLD TAPPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-7026
Mailing Address - Country:US
Mailing Address - Phone:201-248-0777
Mailing Address - Fax:888-462-7765
Practice Address - Street 1:1 BLUE HILL PLZ STE 57
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-3100
Practice Address - Country:US
Practice Address - Phone:201-248-0777
Practice Address - Fax:888-462-7765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty