Provider Demographics
NPI:1881304996
Name:MY WELLNESS CONCIERGE INC
Entity type:Organization
Organization Name:MY WELLNESS CONCIERGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OTERO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:917-304-9024
Mailing Address - Street 1:16036 95TH ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3801
Mailing Address - Country:US
Mailing Address - Phone:917-304-9024
Mailing Address - Fax:
Practice Address - Street 1:15640 CROSSBAY BLVD
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2745
Practice Address - Country:US
Practice Address - Phone:718-529-4500
Practice Address - Fax:718-529-4663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care