Provider Demographics
NPI:1205636289
Name:WELLNESS PHYSICAL MEDICINE & REHABILITATION PC
Entity type:Organization
Organization Name:WELLNESS PHYSICAL MEDICINE & REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HASAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUGHTAI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-527-8688
Mailing Address - Street 1:18016 WEXFORD TER STE CB
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3004
Mailing Address - Country:US
Mailing Address - Phone:718-658-5639
Mailing Address - Fax:718-657-5607
Practice Address - Street 1:18016 WEXFORD TER STE CB
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3004
Practice Address - Country:US
Practice Address - Phone:718-658-5639
Practice Address - Fax:718-657-5607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty