Organization
LB HOLISTIC WELLNESS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA LOURDES BUNQUE NP (CEO)
(646) 455-9008
Entity
Organization
Contact information
Practice address
1940 PALMER AVE, LARCHMONT, NY 10538-2410
(646) 455-9008
(914) 398-6527
Mailing address
1940 PALMER AVE # 5007, LARCHMONT, NY 10538-2410
(646) 455-9008
(914) 398-6527
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/25/2025
Last updated
06/25/2025
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