Organization · NPI-2

Holistic Medical Wellness, PLLC

Emergency Medicine · Port Jefferson Station, NY

NPI number1447790274

StatusActive

Last updated in NPPESFeb 27, 2017

Details

NPI: 1447790274
Entity type: Organization (NPI-2)
Legal business name: Holistic Medical Wellness, PLLC
Organization subpart: Yes
Enumeration date: Feb 27, 2017
Last updated: Feb 27, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207P00000X	Emergency Medicine	230135	NY	Yes

Practice location

11 Medical Dr
Port Jefferson Station, NY 11776-1589

Phone 646-239-1656 · Fax 631-849-5824

Mailing address

Po Box 656
Deer Park, NY 11729-0666

Phone 646-239-1656 · Fax 631-849-5824

Authorized official

Hillel Trope
President/Ceo
6462391656

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.