Provider Demographics
NPI:1851591994
Name:WELLNESS INSTITUTE, INC.
Entity Type:Organization
Organization Name:WELLNESS INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:845-638-4574
Mailing Address - Street 1:337 N MAIN ST
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4310
Mailing Address - Country:US
Mailing Address - Phone:845-638-4574
Mailing Address - Fax:845-638-9436
Practice Address - Street 1:337 N MAIN ST
Practice Address - Street 2:SUITE 6A
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4310
Practice Address - Country:US
Practice Address - Phone:845-638-4574
Practice Address - Fax:845-638-9436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093635207KI0005X
NYN002983213E00000X
NY334278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory ImmunologyGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1104833078OtherNPI
NY1538227699OtherNPI
NY1447315890OtherNPI
NY1982785358OtherNPI