# AVENUE MEDICAL WELLNESS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Lanby
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871252890
- **Authorized official:** STEPHANIE WALLMAN DO (LEAD PHYSICIAN)
- **Authorized official phone:** (646) 200-5750

## Contact information

- **Practice address:** 535 5TH AVE RM 603, NEW YORK, NY 10017-8009
- **Practice address phone:** (646) 200-5750
- **Practice address fax:** (833) 322-1167
- **Mailing address:** 535 5TH AVE RM 603, NEW YORK, NY 10017-8009
- **Mailing address phone:** (646) 200-5757
- **Mailing address fax:** (833) 322-1167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/17/2021
- **Last updated:** 07/28/2026