Organization
MEDICAL AND WELLNESS PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN SOU-CHENG SHIAU MD (PRESIDENT)
(917) 886-5276
Entity
Organization
Contact information
Practice address
554 TOMPKINS AVE, STATEN ISLAND, NY 10305-1745
(877) 241-2772
Mailing address
PO BOX 103, HILLSDALE, NJ 07642-0103
(201) 522-3205
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
11/03/2020
Last updated
02/10/2021
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