Provider Demographics
NPI:1528885613
Name:WELLBEING CLINIC PC
Entity type:Organization
Organization Name:WELLBEING CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COUNCILLOR
Authorized Official - Prefix:
Authorized Official - First Name:MIOK
Authorized Official - Middle Name:
Authorized Official - Last Name:IM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C, PMHNP-B
Authorized Official - Phone:914-751-9426
Mailing Address - Street 1:216 CONGERS RD BLDG 3
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6261
Mailing Address - Country:US
Mailing Address - Phone:914-751-9426
Mailing Address - Fax:
Practice Address - Street 1:216 CONGERS RD BLDG 3
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-6261
Practice Address - Country:US
Practice Address - Phone:914-751-9426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty