Wellness Medical of Corona PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

271367 Issued in NY

Legal business name

WELLNESS MEDICAL OF CORONA PC

Practice address

10005 Roosevelt Ave
Suite 203
Corona, NY 11368-4880

Phone

(718) 803-6430

Fax

(718) 803-6440

NPI assigned

Aug 27, 2015

Last updated

Aug 27, 2015By 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

Mr. Alexander Baldonado, M.D.

Title

Owner

Phone

(347) 825-8288

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hyun Jin Jun, P.T.

  • Physical Therapist
  • Woodside, NY
  • NPI 1629488192
  NPD (past)
• Seung Jo Yoo, DPT

  • Physical Therapist
  • Rego Park, NY
  • NPI 1639434673
  NPD (past)

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1336516210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10005 ROOSEVELT AVE",
            "address_2": "SUITE 203",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113684880",
            "telephone_number": "718-803-6430",
            "fax_number": "718-803-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10005 ROOSEVELT AVE",
            "address_2": "SUITE 203",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113684880",
            "telephone_number": "718-803-6430",
            "fax_number": "718-803-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS MEDICAL OF CORONA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "BALDONADO",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "13478258288",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "271367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rui Wang, SERVICE COORDINATOR
• Yue Wang
• Zhong Wang
• Jonathan Wei
• Wei Wei
• Andrea Denise Williams, RN
• Elizabeth Minaya Wimbley
• Shinhee Won
• Maysue Wong
• Ruoru Wong, PA-C

• Family Medicine Physician in Corona, NY
• Providers in Corona, 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 Aug 27, 2015; 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.