Organization Active NPI

Wayne Family Wellness, LLC

  • Acupuncturist
  • Berwyn, PA
National Provider Identifier
1083185706
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
WAYNE FAMILY WELLNESS, LLC
Practice address
6 Waterloo Ave
Berwyn, PA 19312-1731
Phone
(610) 203-3747
NPI assigned
Dec 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lance Isakov, M.AC., L.AC.
Title
Founder, Acupuncturist
Phone
(610) 203-3747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X Primary

Addresses

Primary practice location

6 Waterloo Ave
Berwyn, PA 19312-1731

Mailing address

6 Waterloo Ave
Berwyn, PA 19312-1731
Phone (610) 203-3747

Other names 1

  • VIllage Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

6 Waterloo Ave
Berwyn, PA 19312
Phone (610) 203-3747

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1083185706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WATERLOO AVE",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121731",
            "telephone_number": "610-203-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WATERLOO AVE",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121731",
            "telephone_number": "610-203-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE FAMILY WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "ISAKOV",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "FOUNDER, ACUPUNCTURIST",
        "authorized_official_telephone_number": "610-203-3747",
        "authorized_official_credential": "M.AC., L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIllage Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berwyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.