# ADVANCE MEDICAL & WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194250456
- **Authorized official:** GINA WHYTE (BUSINESS ADMINISTRATOR)
- **Authorized official phone:** (929) 990-3961

## Contact information

- **Practice address:** 730 RIVERSIDE DR, APT. 4E, NEW YORK, NY 10031-2441
- **Practice address phone:** (917) 580-1875
- **Mailing address:** 730 RIVERSIDE DR, APT. 4E, NEW YORK, NY 10031-2441
- **Mailing address phone:** (917) 580-1875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 7110511 | NY | Yes |

## Other

- **Enumeration date:** 04/25/2017
- **Last updated:** 04/25/2017