Wellness of College Point Medical, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

250526 Issued in NY

Legal business name

WELLNESS OF COLLEGE POINT MEDICAL, P.C.

Practice address

4211 College Point Blvd
Flushing, NY 11355-4230

Phone

(718) 321-9688

Fax

(718) 321-9668

NPI assigned

Aug 19, 2011

Last updated

Aug 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marvin Moy, M.D.

Title

President

Phone

(718) 321-9688

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1316227424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 COLLEGE POINT BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554230",
            "telephone_number": "718-321-9688",
            "fax_number": "718-321-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 COLLEGE POINT BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554230",
            "telephone_number": "718-321-9688",
            "fax_number": "718-321-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS OF COLLEGE POINT MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "MOY",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-321-9688",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "250526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Flushing, NY
• Providers in Flushing, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.