IV Glow and Wellness LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

IV GLOW AND WELLNESS LLC

Practice address

9 Cedar Ave
Medford, NY 11763-3501

Phone

(631) 294-9780

NPI assigned

Jul 22, 2026

Organization subpart

No

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

Authorized official

Name

Mrs. Nicole Ashley Siguencia, NURSE PRACTITIONER

Title

Owner/Provider

Phone

(631) 294-9780

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1784678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1538080908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CEDAR AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633501",
            "telephone_number": "631-294-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CEDAR AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633501",
            "telephone_number": "631-294-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IV GLOW AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-22",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "SIGUENCIA",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "631-294-9780",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Medford, NY
• Providers in Medford, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.