Provider Demographics
NPI:1326842154
Name:CORE WELLNESS PT PC
Entity type:Organization
Organization Name:CORE WELLNESS PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:OWIEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-465-5675
Mailing Address - Street 1:2922 NORTHERN BLVD APT 611
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4083
Mailing Address - Country:US
Mailing Address - Phone:516-250-7051
Mailing Address - Fax:347-465-5675
Practice Address - Street 1:585 STEWART AVE STE 300
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4701
Practice Address - Country:US
Practice Address - Phone:516-250-7051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty