Prime Fitness and Wellness Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRIME FITNESS AND WELLNESS INC

Practice address

167 Brook St
Garden City, NY 11530-6422

Phone

(917) 902-8243

NPI assigned

Sep 23, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Eddie Wong, PTNPI 1013928662

Title

Owner

Phone

(917) 902-8243

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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.

• Eddie Wong, PT

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1013928662
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1720805773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 BROOK ST",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115306422",
            "telephone_number": "917-902-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 BROOK ST",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115306422",
            "telephone_number": "917-902-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME FITNESS AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-22",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-902-8243",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prestige IV Health & Wellness (Vital Infusions)
• Kimberly Presuto, ATC
• Susanna Preuss, LCSW
• Wayne Thomas Prigoff, DDS
• Prime Elite Inc
• Prime Health Medical PC
• Prime Medical Transportation LLC (Prime Ambulette)
• Kristin Rae Princiotta
• Pro Nutrition Counseling PLLC
• Professional Care Management LLC

• Physical Therapist in Garden City, NY
• Providers in Garden City, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.