Provider Demographics
NPI:1861668782
Name:PLATINUM WELLNESS INC.
Entity Type:Organization
Organization Name:PLATINUM WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-452-2400
Mailing Address - Street 1:435 E 77TH ST
Mailing Address - Street 2:#4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-2319
Mailing Address - Country:US
Mailing Address - Phone:212-452-2400
Mailing Address - Fax:212-452-2411
Practice Address - Street 1:400 E 74TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3912
Practice Address - Country:US
Practice Address - Phone:212-452-2400
Practice Address - Fax:212-452-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0162431261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy