MEDICAL WELLNESS PRACTICE PLLC (NPI# 1104427442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104427442 |
| Entity Type | Organization |
| Organization Name | MEDICAL WELLNESS PRACTICE PLLC |
| Practice Address |
554 Tompkins Ave Staten Island NY 10305-1745 |
| Mailing Address |
Po Box 103 Hillsdale NJ 07642-0103 |
| Practice Telephone | 8772412772 |
| Mailing Telephone | 2015223205 |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | DR. JOHN SOU-CHENG SHIAU (PRESIDENT) |
| Authorized Official Telephone | 9178865276 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 110 Business Park Dr, Utica, NY 135026302 | 8772412772 | |
| 139 Fulton St Rm 136, New York, NY 100382538 | 8772412772 |
| Street Address |
554 TOMPKINS AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10305-1745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972101517 | Gina Sinchi | Specialist | 120 Hylan Blvd Suite 9b1, Staten Island, NY 10305 | 2020-10-15 |
| 1003436783 | Ali Kassem | Student in an Organized Health Care Education/Training Program | 475 Seaview University, Staten Island, New York, Staten Island University Hospital, Department of Intern, Staten Island, Nyc, NY 10305 | 2020-04-22 |
| 1174183982 | Mohammad Ass'ad Alshami | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue Ht-257(back), Staten Island-nyc, NY 10305 | 2019-06-14 |
| 1639632508 | Abdullah Jahangir | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue Staten Island, Staten Island Univers, New York City, NY 10305 | 2019-04-09 |
| 1922593813 | Ifeyinwa Mary Asuzu | Student in an Organized Health Care Education/Training Program | 1 Edgewater Plaza Staten Island, New York, NY 10305 | 2018-06-25 |
| 1700377652 | Celeste Jude Chow | Speech-Language Pathologist | 841 Father Capodanno Blvd, Staten Island, NY 10305 | 2018-05-27 |
| 1972094878 | Mahmoud Shadi | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue; Staten Island Univeristy Hospital, Staten Island, NY 10305 | 2018-05-25 |
| 1396235131 | Samyak Hiteshkumar Dhruv | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue, Staten Island, NY 10305 | 2018-05-17 |
| 1720583404 | Michele Corrado | Nurse Practitioner | 27 Xenia St, Staten Island, NY 10305 | 2018-03-26 |
| 1861995912 | Erika Renick | Dietitian, Registered | 256 Mason Avenue, Building C - 3rd Floor, Staten Island, NY 10305 | 2018-03-15 |
| Find all providers in zip 10305 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225211469 | Qusai Hammouri | Orthopaedic Surgery | 256 Mason Ave # C, Staten Island, NY 10305-3408 | 2007-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235691379 | Sny Care of Ny, LLC | Orthopaedic Surgery | 1131 Route 55 Ste 1a, Lagrangeville, NY 12540-5054 | 2019-04-05 |
| 1366903676 | Spine Health Orthopaedics PC | Orthopaedic Surgery | 110 Duane St, New York, NY 10007-1126 | 2019-03-28 |
| 1902388259 | Han Jo Kim Md PC | Orthopaedic Surgery | 541 E 71st St Fl 4, New York, NY 10021-4871 | 2018-09-04 |
| 1073011342 | Joint Replacement Cin of Manhattan LLC | Orthopaedic Surgery | 420 Lexington Ave Rm 300, New York, NY 10170-0399 | 2018-01-31 |
| 1871001750 | Spine Cin of Buffalo LLC | Orthopaedic Surgery | 3725a Walden Ave, Lancaster, NY 14086-1405 | 2018-01-13 |
| 1972011856 | Spine Cin of Hudson Valley LLC | Orthopaedic Surgery | 1131 Route 55 # 1a, Lagrangeville, NY 12540-5054 | 2018-01-13 |
| 1699283572 | Joint Replacement Cin of Hudson Valley LLC | Orthopaedic Surgery | 1131 Route 55 # 1b, Lagrangeville, NY 12540-5054 | 2018-01-13 |
| 1780071548 | Island Musculoskeletal Care Md PC | Orthopaedic Surgery | 10825 Jamaica Ave, Richmond Hill, NY 11418-2243 | 2015-04-20 |
| 1578990669 | Joseph Sae Hyun Pyun | Orthopaedic Surgery | 506 5th Ave, #2ff, Brooklyn, NY 11215-4812 | 2013-10-03 |
| 1568896611 | John Richard Devanny | Orthopaedic Surgery | 56 Danbury Cir S, Rochester, NY 14618-2720 | 2013-08-26 |
| Find all providers with the same taxonomy | ||||
| City | STATEN ISLAND |
| Zip Code | 10305 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.