National Provider Identifier Database

ACTION WELLNESS NP IN FAMILY HEALTH PLLC
Family


Contact Information

ACTION WELLNESS NP IN FAMILY HEALTH PLLC
116 N HURON ST
RONKONKOMA, NY11779-3532
Phone: 631-500-0388
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for ACTION WELLNESS NP IN FAMILY HEALTH PLLC

NPI Number 1295493187
Legal business name
LBN
ACTION WELLNESS NP IN FAMILY HEALTH PLLC
Authorized official MELINDA CLARKE - (OWNER/SOLE MEMBER)
Entity Organization
Organization subpart No
Enumeration date 12/07/2021
Last updated 05/23/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers
  • Other: 1184999344 NPPES - NPI NUMBER
  • NY Other: 344753 NURSE PRACTITIONER LICENSE
  • NY Other: 405889 NYSED BOARD OF NURSING

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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