Organization
ECLIPSE INTEGRATIVE WELLNESS NP IN FAMILY HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PREETHI IDICULLA FNP (OWNER)
(917) 858-0953
Entity
Organization
Contact information
Practice address
3930 RICHMOND AVE, STATEN ISLAND, NY 10312-5104
(917) 300-1231
Mailing address
968 WENDY CT, UNION, NJ 07083-5637
(917) 858-0953
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/06/2025
Last updated
10/22/2025
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