WW Medical Wellness PLLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

WW MEDICAL WELLNESS PLLC

Practice address

1105 Deer Park Ave
North Babylon, NY 11703-3107

Phone

(631) 506-8907

Fax

(631) 506-8909

NPI assigned

Jul 29, 2020

Organization subpart

No

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

Authorized official

Name

Wayne Wertheim, MD

Title

Owner

Phone

(516) 659-1716

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1649889221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 GLEN COVE RD",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771718",
            "telephone_number": "631-506-8907",
            "fax_number": "631-506-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033107",
            "telephone_number": "631-506-8907",
            "fax_number": "631-506-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WW MEDICAL WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "WERTHEIM",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-659-1716",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Hamuel Williams Jr., LPN
• Valarie Williams, MS,CCC-SLP
• Ashley Brooke Wilmot, DMD
• Winthrop Community Medical Affiliates, P.C.
• Winthrop Community Medical Affiliates, PC
• Xtramile LLC
• Laraib Zahid
• Marie Judith Zephirin, REGISTERED NURSE
• Gerald A. Zimmerman, RPH
• Kim Zubrinic, MD

• Pain Medicine Physician in North Babylon, NY
• Providers in North Babylon, NY by specialty
• Pain Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.