Organization Active NPI

Sean Medical Wellness PLLC

  • General Practice Physician
  • Freeport, NY
National Provider Identifier
1255818753
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SEAN MEDICAL WELLNESS PLLC
Practice address
53 W Merrick Rd Ste 2a
Freeport, NY 11520-3709
Phone
(718) 554-1042
NPI assigned
Jul 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Authorized official

Name
Varun Bajaj
Title
Biller
Phone
(718) 554-1042

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

53 W Merrick Rd Ste 2a
Freeport, NY 11520-3709

Mailing address

53 W Merrick Rd Ste 2a
Freeport, NY 11520-3709
Phone (718) 554-1024

National Provider Directory

National Provider Directory

Locations

53 W Merrick Rd
Ste 2A
Freeport, NY 11520

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541980800000",
    "number": "1255818753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 W MERRICK RD STE 2A",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203709",
            "telephone_number": "718-554-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W MERRICK RD STE 2A",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203709",
            "telephone_number": "718-554-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN MEDICAL WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-11-12",
        "status": "A",
        "authorized_official_last_name": "BAJAJ",
        "authorized_official_first_name": "VARUN",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "718-554-1042"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.