Provider Demographics
NPI:1295538023
Name:WHEELOCK ADULT HEALTH NP PLLC
Entity type:Organization
Organization Name:WHEELOCK ADULT HEALTH NP PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELOCK
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:518-332-5041
Mailing Address - Street 1:121 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13452-1021
Mailing Address - Country:US
Mailing Address - Phone:518-332-5041
Mailing Address - Fax:207-910-8413
Practice Address - Street 1:373 MARSHVILLE RD
Practice Address - Street 2:
Practice Address - City:CANAJOHARIE
Practice Address - State:NY
Practice Address - Zip Code:13317-1331
Practice Address - Country:US
Practice Address - Phone:518-332-5041
Practice Address - Fax:207-910-8413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health