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Organization

BLUE LOTUS MEDICAL WELLNESS, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SANJAY SHETTY MD (OWNER)
(917) 589-5109
Entity
Organization

Contact information

Practice address
245 CONKLIN ST, FARMINGDALE, NY 11735-2659
(917) 589-5109
Mailing address
245 CONKLIN ST, FARMINGDALE, NY 11735-2659
(917) 589-5109

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
02/13/2024
Last updated
02/13/2024
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