Organization
STONY BROOK HOLISTIC WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND LOUIS PHD (CFO)
(631) 653-1007
Entity
Organization
Contact information
Practice address
2500 NESCONSET HWY BLDG 26, STONY BROOK, NY 11790-2555
(631) 364-9038
Mailing address
2500 NESCONSET HWY BLDG 26, STONY BROOK, NY 11790-2555
(631) 364-9038
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
225700000X
Massage Therapist
—
—
363L00000X
Nurse Practitioner
Primary
—
—
364SH1100X
Holistic Clinical Nurse Specialist
—
—
Other
Enumeration date
04/07/2025
Last updated
04/25/2026
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