McEvilley Forever Young Wellness, LTD.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MCEVILLEY FOREVER YOUNG WELLNESS, LTD.

Practice address

50 Broadway
Greenlawn, NY 11740-1336

Phone

(347) 439-4983

NPI assigned

Mar 26, 2021

Organization subpart

No

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

Authorized official

Name

Candice Daniels, FNP

Title

Owner

Phone

(347) 439-4983

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1194302950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BROADWAY",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401336",
            "telephone_number": "347-439-4983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BROADWAY",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401336",
            "telephone_number": "347-439-4983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCEVILLEY FOREVER YOUNG WELLNESS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-439-4983",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina J Lyons, RN
• Lindsay Macchia, PH.D.
• Mark Gennaro MD PC
• Mark Gennaro MD PC
• Rachel McCullough
• Jamie McGuire
• Susan Jean McKenna, RRT
• Shaun McLeod, L.C.S.W.
• Maria McRobb, RPAC
• Margo Posillico Messina, LCSW-R

• Family Medicine Physician in Greenlawn, NY
• Providers in Greenlawn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.