Provider Demographics
NPI:1851075345
Name:BE TOTALLY WELL LLC
Entity Type:Organization
Organization Name:BE TOTALLY WELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:NICOLEAU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:347-869-1581
Mailing Address - Street 1:980 CRAMER CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1215
Mailing Address - Country:US
Mailing Address - Phone:347-869-1581
Mailing Address - Fax:
Practice Address - Street 1:2570 HEMPSTEAD TPKE UNIT 2
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2146
Practice Address - Country:US
Practice Address - Phone:516-548-0600
Practice Address - Fax:516-548-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty