Prestige IV Health & Wellness

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

PRESTIGE IV HEALTH & WELLNESS

Practice address

1325 Franklin Ave
Garden City, NY 11530-1666

Phone

(347) 306-0338

NPI assigned

Jul 7, 2021

Organization subpart

No

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

Authorized official

Name

Yasmin Merouane

Title

Administrator

Phone

(347) 306-0338

Specialties & licenses 1

Addresses

Other names 1

• Vital Infusions Doing business as

Locations

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1508437880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 TRAVIS AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301666",
            "telephone_number": "347-306-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE IV HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2022-09-07",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "MEROUANE",
        "authorized_official_first_name": "YASMIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "347-306-0338"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vital Infusions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sudha Manjari Prasad
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• Kimberly Presuto, ATC
• Susanna Preuss, LCSW
• Wayne Thomas Prigoff, DDS
• Prime Elite Inc
• Prime Fitness and Wellness Inc

• Infusion Therapy Clinic/Center in Garden City, NY
• Providers in Garden City, NY by specialty
• Infusion Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.