OrganizationActive
Wellness Health Medical Provider, P.C.
NPI 1336856830 · Primary Care Clinic/Center · East Northport, NY
Provider details
- NPI number
- 1336856830
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Boshardy, Vp of Legal(773) 814-3028
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1 Laura Ln
East Northport, NY 11731-4700
Phone: (949) 325-7001
Street-level locationGet directions
Mailing address
17981 Sky Park Cir, Bldg 39, Ste Bc
Irvine, CA 92614-6309
Registry dates
- Enumerated
- 2022-11-03
- Last updated
- 2022-11-03
- Certified
- 2022-10-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.