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Organization
WELLNESS FUNDAMENTALS INC.
Active
Organization
WELLNESS FUNDAMENTALS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRAINE JAYSURA NP (OFFICER)
(917) 346-1806
Entity
Organization
Contact information
Practice address
100 ALCOTT PL APT 4K, BRONX, NY 10475-4153
(917) 346-1806
Mailing address
PO BOX 651, BRONX, NY 10475-0651
(917) 346-1806
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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