Provider Demographics
NPI:1306513015
Name:HEALTHY HEIGHTS: WELLNESS & WEIGHT LOSS CLINIC LLC
Entity type:Organization
Organization Name:HEALTHY HEIGHTS: WELLNESS & WEIGHT LOSS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIURKA
Authorized Official - Middle Name:J
Authorized Official - Last Name:VISCONTI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-930-7515
Mailing Address - Street 1:100 CORPORATE DR UNIT B104
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-6346
Mailing Address - Country:US
Mailing Address - Phone:718-930-7515
Mailing Address - Fax:713-554-1367
Practice Address - Street 1:100 CORPORATE DR UNIT B104
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-6346
Practice Address - Country:US
Practice Address - Phone:718-930-7515
Practice Address - Fax:713-554-1367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty