Provider Demographics
NPI:1851922215
Name:WELLNESS MEDICAL DOCTOR P.C.
Entity Type:Organization
Organization Name:WELLNESS MEDICAL DOCTOR P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRESCHNACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-232-6492
Mailing Address - Street 1:2818 31ST ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1745
Mailing Address - Country:US
Mailing Address - Phone:718-956-6565
Mailing Address - Fax:718-721-8406
Practice Address - Street 1:2818 31ST ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1745
Practice Address - Country:US
Practice Address - Phone:718-956-6565
Practice Address - Fax:718-721-8406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty