Refined Medical Wellness, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REFINED MEDICAL WELLNESS, PLLC

Practice address

3400 Nesconset Hwy Ste 104
East Setauket, NY 11733-3327

Phone

(516) 704-7447

NPI assigned

Oct 24, 2023

Last updated

Oct 24, 2023By 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

Nycholle Gavilanes, MDNPI 1699941971

Title

Member

Phone

(516) 704-7447

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.

• Nycholle Lynne Gavilanes, MD

  • Internal Medicine Physician
  • East Setauket, NY
  • NPI 1699941971
  Authorized official Same address or phone
• Christopher Koch, PA

  • Physician Assistant
  • East Setauket, NY
  • NPI 1780858951
  NPD

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1831961796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 NESCONSET HWY STE 104",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 NESCONSET HWY STE 104",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333327",
            "telephone_number": "516-704-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFINED MEDICAL WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "GAVILANES",
        "authorized_official_first_name": "NYCHOLLE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "516-704-7447",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Raju, M.D.
• Sritha Rajupet, M.D.
• Nirupa Ramjisingh, PA
• Renise Marie Rancy, RN
• Alexis Rebori
• Colleen Reilly
• Grace E Reina, M.D.
• Sally Anne J Rexach, FNP-C
• Dorothy J Reynolds, M.D.
• Thomas P Ribaudo, MD

• Clinic/Center in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.