Provider Demographics
NPI:1841884905
Name:ENLIGHTENMENT WELLNESS CORP
Entity type:Organization
Organization Name:ENLIGHTENMENT WELLNESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YING
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:701-730-6246
Mailing Address - Street 1:7216 ROOSEVELT AVE # 2R
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6335
Mailing Address - Country:US
Mailing Address - Phone:347-808-8033
Mailing Address - Fax:888-502-9368
Practice Address - Street 1:7216 ROOSEVELT AVE # 2R
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6335
Practice Address - Country:US
Practice Address - Phone:347-808-8033
Practice Address - Fax:888-502-9368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty