Provider Demographics
NPI:1588332753
Name:STELWIN HEALTH AND WELLNESS CENTER LLC
Entity type:Organization
Organization Name:STELWIN HEALTH AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGWIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-943-5606
Mailing Address - Street 1:176 TOLL GATE RD STE 302
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4481
Mailing Address - Country:US
Mailing Address - Phone:617-943-5606
Mailing Address - Fax:
Practice Address - Street 1:176 TOLL GATE RD STE 302
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4481
Practice Address - Country:US
Practice Address - Phone:617-943-5606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty