Organization
ACTION WELLNESS NP IN FAMILY HEALTH PLLC
Active
Organization
ACTION WELLNESS NP IN FAMILY HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA CLARKE NP (OWNER/SOLE MEMBER)
(631) 500-0388
Entity
Organization
Contact information
Practice address
116 N HURON ST, RONKONKOMA, NY 11779-3532
(631) 500-0388
Mailing address
116 N HURON ST, RONKONKOMA, NY 11779-3532
(631) 500-0388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184999344
NPPES - NPI NUMBER
—
01
—
344753
NURSE PRACTITIONER LICENSE
NY
01
—
405889
NYSED BOARD OF NURSING
NY
Enumeration date
12/07/2021
Last updated
05/23/2024
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