# NASSAU COUNTY WELLCARE MEDICAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pure Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811688955
- **Authorized official:** EVAN SHAPIRO MD (OWNER)
- **Authorized official phone:** (516) 208-7600

## Contact information

- **Practice address:** 87 S OCEAN AVE, PATCHOGUE, NY 11772-3702
- **Practice address phone:** (516) 412-7873
- **Practice address fax:** (631) 506-8909
- **Mailing address:** 1300 UNION TPKE STE 206, NEW HYDE PARK, NY 11040-1759
- **Mailing address phone:** (631) 506-8907
- **Mailing address fax:** (631) 315-2166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/18/2023
- **Last updated:** 05/18/2023