Provider Demographics
NPI:1427811306
Name:DARWISH WELLNESS MEDICAL OFFICE PC
Entity type:Organization
Organization Name:DARWISH WELLNESS MEDICAL OFFICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DARWISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-272-6607
Mailing Address - Street 1:180 GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2640
Mailing Address - Country:US
Mailing Address - Phone:718-887-4061
Mailing Address - Fax:
Practice Address - Street 1:299 GUYON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4108
Practice Address - Country:US
Practice Address - Phone:718-887-4061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty