Provider Demographics
NPI:1649002858
Name:MY WELLNESS MEDICAL PLLC
Entity type:Organization
Organization Name:MY WELLNESS MEDICAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHADHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-335-3403
Mailing Address - Street 1:98 CARAMEL RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-1000
Mailing Address - Country:US
Mailing Address - Phone:631-335-3403
Mailing Address - Fax:
Practice Address - Street 1:356 VETERANS MEMORIAL HWY STE 5
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4332
Practice Address - Country:US
Practice Address - Phone:631-335-5532
Practice Address - Fax:631-292-2019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty